SHANNON WALLACE


Address: 636 Candyce Ave, Lakeland, FL 33815-1202
Phone: 8636144071

SHANNON WALLACE (NPI# 1750757340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750757340
Entity Type Individual
Full Name SHANNON WALLACE
Credential HOME HEATH AIDE
Practice Address 636 Candyce Ave
Lakeland
FL 33815-1202
Mailing Address 636 Candyce Ave
Same
Lakeland
FL 33815-1202
Practice Telephone 8636144071
Mailing Telephone 8636144071
Enumeration Date 2015-08-18
Last Update Date 2015-08-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 374U00000X Home Health Aide Nursing Service Related Providers

Other Providers SHANNON WALLACE

NPI Name Taxonomy Address Enumeration
1588142574 Shannon Wallace Specialist 8777 254th St, Bellerose, NY 11426-2329 2018-08-01
1891223293 Shannon May Wallace Nurse Practitioner 700 Childrens Dr Fl Hall1, Columbus, OH 43205-2664 2017-05-30
1538609847 Shannon Wallace Behavior Technician 841 Hughes Ln, Highlands Ranch, CO 80126-4746 2017-03-06
1205102092 Shannon Leigh Wallace Obstetrics & Gynecology Cleveland Clinic 9500 Euclid Avenue, Cleveland, OH 44195-1705 2012-03-27
1730328840 Shannon D Wallace Behavioral Analyst 3954 Murphy Canyon Rd, Suite D105, San Diego, CA 92123-4418 2009-02-12
1437707452 Shannon Wallace Physical Therapy Assistant 3108 Circle Dr, White Pine, TN 37890-3306 2019-09-03
1598103111 Shannon R Wallace Physician Assistant 5818 D Harbour View Blvd, Suite 150, Suffolk, VA 23435-3327 2013-06-05
1326290982 Shannon Mcnally Wallace Social Worker 3010 Falstaff Rd, Raleigh, NC 27610-1813 2008-10-15
1851481584 Shannon L Wallace Nurse Practitioner 1001 W 10th St, Er/uvc, Indianapolis, IN 46202-2859 2006-10-13

Office Location

Street Address 636 CANDYCE AVE
City LAKELAND
State FL
Zip Code 33815-1202

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174162093 Deborah Beall Boynton Counselor 219 Hillcrest St, Lakeland, FL 33815 2019-12-23
1992247373 Lizvel Rosario Counselor 220 Lake Wire Dr., Lakeland, FL 33815 2016-11-16
1235554783 Florida Baptist Children's Homes Community Based Residential Treatment Facility, Mental Illness 1015 Sikes Blvd., Lakeland, FL 33815 2014-02-20
1902229255 Christina Miller Nurse Practitioner 6850 New Tampa Hwy Ste 600, Lakeland, FL 33815 2014-01-22
1902111099 Jeanene Nicole Robinson-kyles Psychologist 505 Martin L. King Jr. Ave, Suite 1, Lakeland, FL 33815 2010-08-12
1235287095 Wendell Owen Blake Family Medicine 505 Martin Luther King Ave, Suite 2, Lakeland, FL 33815 2007-01-08
1104983899 Lake Wire Pharmacy Inc Pharmacist 505 Martin Luther King Jr Ave, Suite 3, Lakeland, FL 33815 2007-01-02
1427038637 Rotech Oxygen and Medical Equipment Inc Durable Medical Equipment & Medical Supplies 5315 Great Oak Drive, Lakeland, FL 33815 2006-01-23
1598205841 Daphne Toussaint Dentist 607 S Missouri Ave, Lakeland, FL 33815 2017-03-06
1083936058 Blake and Franklin Md Pa General Practice 505 Martin Luther King Jr Ave, Ste 2, Lakeland, FL 33815 2010-02-18
Find all providers in zip 33815

Taxonomy Information

Taxonomy Code 374U00000X
Grouping Nursing Service Related Providers
Classification Home Health Aide

Taxonomy Definition

A person trained to assist public health nurses, home health nurses, and other health professionals in the bedside care of patients in their homes.
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932719242 Jimia Watkins Home Health Aide 2410 Lakeview St, Lakeland, FL 33801 2020-08-03
1881215663 Demetria L Mcgee Home Health Aide 1820 Salem Rd, Lakeland, FL 33803-2550 2020-05-03
1619513397 Karen Shepherd Green Home Health Aide 2946 N Martha Ave, Lakeland, FL 33805-2240 2019-11-18
1912549924 Ray Carla Pennick Home Health Aide 4278 Whistlewood Cir, Lakeland, FL 33811-3052 2019-10-10
1154814440 Theressa W Hadley Home Health Aide 1422 Kettles Ave, Lakeland, FL 33805-3664 2018-06-11
1396252540 Ariel Brown Home Health Aide 303 N Brunnell Pkwy Apt 51, Lakeland, FL 33815-1245 2018-01-09
1902261415 Seanquanee Denazia Laster Home Health Aide 1603 Goodyear Ave, Lakeland, FL 33801-7030 2015-12-28
1043699051 Ilene Shumaker Griffin Home Health Aide 2930 Oak Tree Ln, Lakeland, FL 33810 2015-05-22
1437769239 Shannen J Lasane Home Health Aide 4006 Golf Village Loop Apt 2, Lakeland, FL 33809-4056 2020-08-06
1336661883 Kimberly Draine Home Health Aide 1112 W 12th St, Lakeland, FL 33805-3465 2017-07-15
Find all providers in LAKELAND

Competitor

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City LAKELAND
Zip Code 33815

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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