LISA CATHERINE SIMS WALLACE


Address: 421 West College St, Infants and Childrens Clinic PC, Florence, AL 35630
Phone: 2567649522

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
1756561 AL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AL BC 51030973 01

Other Providers LISA WALLACE

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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

Office Location

Street Address 421 WEST COLLEGE ST
INFANTS AND CHILDRENS CLINIC PC
City FLORENCE
State AL
Zip Code 35630

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City FLORENCE
Zip Code 35630

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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