LISA CATHERINE SIMS WALLACE (NPI# 1770594400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770594400 |
Entity Type | Individual |
Full Name | LISA CATHERINE SIMS WALLACE |
Credential | CRNP |
Practice Address |
421 West College St Infants and Childrens Clinic PC Florence AL 35630 |
Mailing Address |
421 West College St Florence AL 35630 |
Practice Telephone | 2567649522 |
Practice Fax Number | 2567641139 |
Mailing Telephone | 2567649522 |
Mailing Fax Number | 2567641139 |
Enumeration Date | 2006-08-10 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
1756561 | AL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AL | BC | 51030973 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396368064 | Lisa Jean Wallace | Occupational Therapy Assistant | 480 Somerset St Unit 1, North Plainfield, NJ 07060-4018 | 2020-05-28 |
1336779925 | Lisa Wallace | Counselor | 2769 Iris Ave Ste 107, Boulder, CO 80304-4405 | 2020-01-22 |
1710521968 | Lisa Anne Wallace | Counselor | 418 Barr Rd, Lexington, SC 29072-2363 | 2019-10-31 |
1598225930 | Lisa Buckner Wallace | Counselor | 3750 N Center St, Hickory, NC 28601-8089 | 2019-03-21 |
1235637182 | Lisa M. Wallace | Nurse Practitioner | 800 E Cheves St Ste 200, Florence, SC 29506-2651 | 2018-01-25 |
1134575475 | Lisa Wallace | Counselor | 14 Farmer Rd, Milton, MA 02186-3743 | 2016-05-05 |
1720476641 | Lisa Wallace | Registered Nurse | 7601 Hospital Dr Ste 202, Sacramento, CA 95823-5408 | 2014-12-30 |
1134438286 | Lisa M Wallace | Nurse Practitioner | 831 N Theatre Drive, Marion, IN 46952-1701 | 2010-10-06 |
1124002571 | Lisa M Wallace | Counselor | 1807 Capitol Ave, Suite 101 A, Cheyenne, WY 82001-4544 | 2005-11-30 |
1003423658 | Lisa Carol Wallace | Nurse Practitioner | 2418 180th St, Allerton, IA 50008-8715 | 2020-09-28 |
Street Address |
421 WEST COLLEGE ST INFANTS AND CHILDRENS CLINIC PC |
City | FLORENCE |
State | AL |
Zip Code | 35630 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700894714 | Grant R Allen | Pediatrics | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
1184760159 | Donna Lynn Montgomery | Nurse Practitioner | 421 West College St, Florence, AL 35630 | 2007-01-29 |
1689685315 | Infants and Childrens Clinic PC | Pediatrics | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-10 |
1497766125 | Wendy A Darby | Nurse Practitioner | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-10 |
1073521084 | Richetta T Huffman-parker | Pediatrics | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
1275541294 | Janice Neal Kidd | Nurse Practitioner | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
1750399770 | Erika Wunderlich Crenshaw | Pediatrics | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
1093723017 | John Hamilton | Pediatrics | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
1366450389 | Jeffrey S Cornelius | Nurse Practitioner | 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630 | 2006-08-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346880531 | Rachel E Belue | Counselor | 409 N. Court Street, Florence, AL 35630 | 2020-01-15 |
1154857746 | Danish Henry | Internal Medicine | North Alabama Medical Center, 1701 Veterans Dr, Florence, AL 35630 | 2017-05-03 |
1396118261 | Three Oaks Pharmacy LLC | Pharmacy | 861 Cox Creek Parkway, Florence, AL 35630 | 2015-11-02 |
1235501891 | Wellness Walk-in Clinic, LLC | Nurse Practitioner | 2612 Hough Road, Florence, AL 35630 | 2015-10-22 |
1972995207 | Elyse Angel | Pharmacist | 109 East Dr Hicks Blvd, Florence, AL 35630 | 2015-02-24 |
1750772380 | Whitlee Laina Kelley | Case Manager/Care Coordinator | 112 Titan Drive, Florence, AL 35630 | 2015-02-18 |
1942612155 | Hillary Jean Delarosa | Internal Medicine | 162 Titan Drive, Florence, AL 35630 | 2014-05-22 |
1952723678 | Sharron M Boatwright | Nurse Practitioner | 1949 Florence Boulevard, Occupational Health Center LLC, Florence, AL 35630 | 2014-01-15 |
1194160523 | Caryn Barnett | Physical Therapist | 412 S. Court Street, Suite 403, Florence, AL 35630 | 2013-04-29 |
1396074662 | Heather White Bryant | Counselor | 118 East Mobile St, Suite 106, Florence, AL 35630 | 2009-12-16 |
Find all providers in zip 35630 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972805190 | Care House of The Pee Dee Inc | Nurse Practitioner | 1500 Patton Dr, Florence, SC 29501-6520 | 2010-11-19 |
1225178460 | Nothwest Alabama Childrens Advocacy Center, Inc | Nurse Practitioner | 404 W Tennessee St, Florence, AL 35630-5525 | 2007-02-07 |
1316958036 | Connie M Arnold | Nurse Practitioner | 3909 Pasadena Ave, Florence, AL 35633-1132 | 2006-08-10 |
1902455595 | Taylor R King | Nurse Practitioner | 421 W College St, Florence, AL 35630-5520 | 2019-09-06 |
1275002123 | Elizabeth Lynn Combs | Nurse Practitioner | 45 Cavalier Blvd, Florence, KY 41042-1684 | 2018-11-21 |
1083098305 | Charlotte Ellis | Nurse Practitioner | 7409 Us 42, Florence, KY 41042-1905 | 2015-07-16 |
1700289147 | Laura Ruthven Bulloch | Nurse Practitioner | 1530 Mclure Ct, Florence, SC 29505-6174 | 2014-09-30 |
1437585825 | Amanda Leigh Race | Nurse Practitioner | 59 Cavalier Blvd, Suite 330, Florence, KY 41042-3901 | 2013-09-18 |
1992957138 | Jessica Lea Ester | Nurse Practitioner | 7309 Us 42, Florence, KY 41042-5561 | 2008-10-21 |
1184760159 | Donna Lynn Montgomery | Nurse Practitioner | 421 West College St, Florence, AL 35630 | 2007-01-29 |
Find all providers in FLORENCE |
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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.