KIMBERLY WALLACE (NPI# 1750785622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750785622 |
| Entity Type | Individual |
| Full Name | KIMBERLY WALLACE |
| Credential | LPN |
| Practice Address |
138 North Court Street Wampsville NY 13163 |
| Mailing Address |
2401 Clark Rd Canastota NY 13032-4759 |
| Practice Telephone | 3153662490 |
| Mailing Telephone | 3153968515 |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2014-10-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 290441 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033457791 | Kimberly Wallace | Physical Therapist | 421 W School House Ln Unit 2, Philadelphia, PA 19144-4557 | 2013-01-30 |
| 1942592340 | Kimberly Wallace | Counselor | 1427 Se 182nd Ave, Portland, OR 97233-5008 | 2011-05-04 |
| 1669794137 | Kimberly Wallace | Registered Nurse | 214 Rosewood Ter, Cheektowaga, NY 14225-3016 | 2010-02-24 |
| 1770627705 | Kimberly Shannon Wallace | Family Medicine | 1438 Defense Hwy Suite 201, Gambrills, MD 21054 | 2007-02-15 |
| 1144881640 | Kimberly Veronica Wallace | Advanced Practice Midwife | 100 Lillian Gish Blvd Sw Ste 201, Massillon, OH 44647-6500 | 2019-06-25 |
| 1316413271 | Kimberly Pauline Wallace | Pharmacist | 951 Central St, Franklin, NH 03235-2028 | 2018-10-18 |
| 1942705223 | Kimberly Wallace | Technician | 1312 S 8th St, Las Vegas, NV 89104-1638 | 2018-03-28 |
| 1043713936 | Kimberly Louise Wallace | Registered Nurse | 2040 Babcock Rd Ste 304, San Antonio, TX 78229-4428 | 2018-03-16 |
| 1265969133 | Kimberly Wallace | Registered Nurse | 3400 Bainbridge Ave, Bronx, NY 10467-2404 | 2017-05-22 |
| 1083091987 | Kimberly Wallace | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2015-04-29 |
| Street Address |
138 NORTH COURT STREET |
| City | WAMPSVILLE |
| State | NY |
| Zip Code | 13163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437196227 | Amintha M. Selvarajah | Physician Assistant | 138 North Court Street, Wampsville, NY 13163-0608 | 2006-06-01 |
| 1003365792 | Stephanie Ann Thompson | Social Worker | 138 North Court Street, Wampsville, NY 13163 | 2016-09-23 |
| 1922495282 | Kathryn Elizabeth Scheirer | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2015-04-23 |
| 1043603822 | Alexa Brayman | Social Worker | 138 North Court Street, #7, Wampsville, NY 13163 | 2015-03-18 |
| 1588905327 | Kirin A Quonce | Social Worker | 138 North Court Street, Veterans Memorial Building, Wampsville, NY 13163 | 2013-03-04 |
| 1770848152 | Shelley Petersen | Specialist | 138 North Court Street, Wampsville, NY 13163-0605 | 2012-07-11 |
| 1700148079 | Lori Brockway | Case Manager/Care Coordinator | 138 North Court Street, Wampsville, NY 13163-0605 | 2012-06-13 |
| 1336428259 | Shannon K Birmingham | Psychologist | 138 North Court Street, Wampsville, NY 13163-0608 | 2011-08-09 |
| 1346542198 | Stephanie Ann Anderson | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2010-11-30 |
| 1447443437 | Teisha Marie Cook | Social Worker | 138 North Court Street, Wampsville, NY 13163-0608 | 2007-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164824462 | Beth Perry | Social Worker | 138 N Court Street, Wampsville, NY 13163 | 2014-09-18 |
| 1659529949 | Timothy Gerard Brown | Social Worker | 138 N. Court St, Wampsville, NY 13163 | 2008-08-29 |
| 1477752376 | Muftah A. Kadura, Md | Internal Medicine | 235 Genesee St, Wampsville, NY 13163 | 2007-07-12 |
| 1881719888 | Kenneth Edward Hefty | Counselor | 138 North Court Rd, Wampsville, NY 13163 | 2007-03-20 |
| 1518990811 | Denise Michelle Calcagnino | Counselor | Veterans Memorial Building, North Court Street, Wampsville, NY 13163 | 2006-07-09 |
| 1871157065 | Mallory Kleps | Counselor | 138 N Court St, Wampsville, NY 13163 | 2019-04-24 |
| 1861968968 | Mark James Miller | Social Worker | 138 North Court St, Wampsville, NY 13163 | 2018-10-17 |
| 1881194611 | Christina Labella | Counselor | 138 N. Court Street, Wampsville, NY 13163 | 2018-02-19 |
| 1083143358 | Megan Mcpeak | Social Worker | 138 N. Court St., Wampsville, NY 13163 | 2017-06-08 |
| 1568999175 | Madison County Health Deptartment | Case Manager/Care Coordinator | 138 North Court St, Wampsville, NY 13163 | 2017-05-12 |
| Find all providers in zip 13163 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033518444 | Denice Ann Townsend | Licensed Practical Nurse | 138 North Court St, Wampsville, NY 13163 | 2014-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780503 | Michael Lee Hendryx | Licensed Practical Nurse | 803 Bell St, Olean, NY 14760-3005 | 2020-11-06 |
| 1720689664 | Chynna S Brown | Licensed Practical Nurse | 483 Newbury St, Rochester, NY 14615-3209 | 2020-11-06 |
| 1588265433 | Deanna Lucas | Licensed Practical Nurse | 206 Prospect Pl, Bay Shore, NY 11706-1537 | 2020-11-06 |
| 1659972511 | Katiesianna Marie Kovalsky | Licensed Practical Nurse | 718 Griswold Hts, Troy, NY 12180-5168 | 2020-11-05 |
| 1538760608 | Shanequa Marshall | Licensed Practical Nurse | 100 Park Ave Apt 1, Amityville, NY 11701-3165 | 2020-11-05 |
| 1780285007 | Jarleyn Severino | Licensed Practical Nurse | 10 Waterview Pl, Lynbrook, NY 11563-1921 | 2020-11-03 |
| 1023619590 | Lisa A Loomis | Licensed Practical Nurse | 2198 Us Highway 20, Nassau, NY 12123-1733 | 2020-11-02 |
| 1235739061 | Kathleen Zalamea | Licensed Practical Nurse | 37 Howells Rd, Bay Shore, NY 11706-6502 | 2020-10-30 |
| 1649870494 | Khairat Salami | Licensed Practical Nurse | 1538 Washington Ave Apt 1, Bronx, NY 10457-8334 | 2020-10-30 |
| 1518567437 | Catherine Grullon | Licensed Practical Nurse | 32 Crescent Ave, Newburgh, NY 12550-3134 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | WAMPSVILLE |
| Zip Code | 13163 |
Please comment or provide details below to improve the information on KIMBERLY WALLACE.
| 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.