MICHELLE WALLACE (NPI# 1770051252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770051252 |
| Entity Type | Individual |
| Full Name | MICHELLE WALLACE |
| Practice Address |
1515 Sumac Rd Fort Gibson OK 74434-7512 |
| Practice Telephone | 9186165408 |
| Mailing Telephone | 9186165408 |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437524196 | Michelle Wallace | Physical Therapist | 473 Auxier Dr, Cincinnati, OH 45244-2364 | 2015-12-07 |
| 1497091805 | Michelle Lynn Wallace | Specialist | 508 Blair Blvd, Eugene, OR 97402-4630 | 2012-12-13 |
| 1477808947 | Michelle Wallace | Physical Medicine & Rehabilitation | 75 Norman Pl, Tenafly, NJ 07670-2537 | 2012-07-19 |
| 1598884272 | Michelle Marie Wallace I | Registered Nurse | 17887 State Route 58, Wellington, OH 44090-9464 | 2007-03-27 |
| 1336796374 | Michelle Wallace | Counselor | 369 Ne Revere Ave Ste 101, Bend, OR 97701-4082 | 2019-08-23 |
| 1316471790 | Michelle Dianne Wallace | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2017-04-12 |
| 1972044519 | Michelle D Wallace | Durable Medical Equipment & Medical Supplies | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2017-03-15 |
| 1275938185 | Michelle Mayer Wallace | Pharmacist | 2413 Highway 431 North, Anniston, AL 36206 | 2014-11-04 |
| 1912249822 | Michelle M Wallace | Physical Therapist | 2300 Trenton Rd, Levittown, PA 19056-1423 | 2013-03-19 |
| 1609136266 | Michelle Wallace | Social Worker | 245 E 19th St, Apt. 12f, New York, NY 10003-2639 | 2012-05-16 |
| Street Address |
1515 SUMAC RD |
| City | FORT GIBSON |
| State | OK |
| Zip Code | 74434-7512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326323296 | Janet Hulbert | Occupational Therapist | 1409 Saddlebrooke Dr, Fort Gibson, OK 74434 | 2011-10-11 |
| 1356643936 | Justin Matthew Wedman | Pharmacist | 114 N. Lee St., Fort Gibson, OK 74434 | 2010-12-02 |
| 1396980546 | Walker & Walker P.l.l.c. | Dentist | 106 Lone Oak Cr, Ft. Gibson, OK 74434 | 2008-12-02 |
| 1548305857 | Christopher Back | Family Medicine | 129 N Lee St., Fort Gibson, OK 74434 | 2007-02-21 |
| 1982794442 | Wanda Ann Teague | Speech-Language Pathologist | 500 South Ross Ave., Fort Gibson, OK 74434 | 2006-10-13 |
| 1891898912 | Scotts Pharmacy LLC | Pharmacy | 1201 S Lee St, Fort Gibson, OK 74434 | 2006-09-06 |
| 1831206671 | Charles Robert Mutch | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| 1073511184 | Brandon Medical, LLC | Prosthetic/Orthotic Supplier | 110 North Lee Street, Fort Gibson, OK 74434 | 2005-07-12 |
| 1265761381 | Holly Jean Dawson | Obstetrics & Gynecology | 108 Lone Oak Cir, Fort Gibson, OK 74434 | 2009-12-19 |
| 1790892529 | Donald M Elgin | Family Medicine | 104 Lone Oak Circle, Ft. Gibson, OK 74434 | 2006-08-25 |
| Find all providers in zip 74434 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992274518 | Sally Lim | Technician | 1212 E Poplar St Apt 20, Fort Gibson, OK 74434-8375 | 2018-11-14 |
| 1265900849 | Johnice Nunley | Technician | 4982 W 797 Rd, Fort Gibson, OK 74434-7204 | 2018-11-13 |
| 1093283962 | Lynn Mccomb | Technician | 4682 W Weeping Rock Rd, Fort Gibson, OK 74434-7205 | 2018-11-08 |
| 1861960304 | Renita Hammack | Technician | 22170 N 4 Mile Rd, Fort Gibson, OK 74434-6096 | 2018-11-02 |
| 1073081519 | Cindy Farmer | Technician | 612 W Hickory Ave, Fort Gibson, OK 74434-8917 | 2018-11-02 |
| 1700355112 | Casey Bear | Technician | 500 Ross Ave, Fort Gibson, OK 74434-8422 | 2018-11-14 |
| 1144799552 | Denise I Littlepage | Technician | 500 Ross Ave, Fort Gibson, OK 74434-8422 | 2018-11-14 |
| 1184193708 | Cynthia A Andrews | Technician | 500 Ross Ave, Fort Gibson, OK 74434-8422 | 2018-11-14 |
| 1962970558 | Kathleen Pinion | Technician | 500 Ross Ave, Fort Gibson, OK 74434-8422 | 2018-11-13 |
| 1265900237 | Melissa Kirkendall | Technician | 500 Ross Ave, Fort Gibson, OK 74434-8422 | 2018-11-08 |
| Find all providers in FORT GIBSON | ||||
| City | FORT GIBSON |
| Zip Code | 74434 |
Please comment or provide details below to improve the information on MICHELLE 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.