MRS. DEBRA ANN WALLACE (NPI# 1912149188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912149188 |
| Entity Type | Individual |
| Full Name | MRS. DEBRA ANN WALLACE |
| Practice Address |
5608 Kenny Dr Tampa FL 33617-7711 |
| Practice Telephone | 8135464884 |
| Practice Fax Number | 8139831860 |
| Mailing Telephone | 8135464884 |
| Mailing Fax Number | 8139831860 |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2009-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 372600000X | Adult Companion | 684206296 | FL | Nursing Service Related Providers |
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
684206296 | FL | Nursing Service Related Providers |
| N | 3747P1801X |
Technician Specialization: Personal Care Attendant |
684206296 | FL | Nursing Service Related Providers |
| Y | 376K00000X | Nurse's Aide | CNA 54979 | FL | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 14627300 | 05 | |
| FL | 684206296 | 05 | |
| FL | CNA | CNA54979 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006538 | Debra Ann Wallace | Surgery | 1100 N State Street, Clinic Tower A6a231a, Los Angeles, CA 90033 | 2017-07-24 |
| 1598005019 | Debra Wallace | Marriage & Family Therapist | 27979 N Converse Rd, Island Lake, IL 60042-8103 | 2013-02-20 |
| 1619271228 | Debra J Wallace | Counselor | 1207 W State St, Suite F, Alliance, OH 44601-4686 | 2010-12-23 |
| 1285877464 | Debra Wallace | Registered Nurse | 50 Redfield St, Suite 302, Dorchester, MA 02122-3630 | 2009-04-17 |
| 1962612168 | Debra Elaine Wallace | Dental Hygienist | 210 Jones Rd, Falmouth, MA 02540-2974 | 2007-05-23 |
| 1164570065 | Debra R Wallace | Nurse Practitioner | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-01-08 |
| 1174631121 | Debra J Wallace | Social Worker | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-08-29 |
| 1033186911 | Debra J Wallace | Family Medicine | 1284 Us Highway 60 W, Morganfield, KY 42437-6236 | 2006-03-01 |
| Street Address |
5608 KENNY DR |
| City | TAMPA |
| State | FL |
| Zip Code | 33617-7711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275892564 | Debra's Divine Care Inc | Home Health | 5608 Kenny Dr, Tampa, FL 33617-7711 | 2012-05-08 |
| 1740591718 | Debra's Divine Care LLC | Home Health | 5608 Kenny Dr, Tampa, FL 33617-7711 | 2010-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253195 | Kare Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 7860 North 56th Street, Tampa, FL 33617 | 2020-04-10 |
| 1942840467 | Care Medrx LLC | Pharmacy | 311 Bullard Pkwy Ste. B, Temple Terrace, FL 33617 | 2020-01-13 |
| 1467004804 | Favorite Care Services, LLC | In Home Supportive Care | 7628 N 56th St Ste 2, Tampa, FL 33617 | 2019-07-16 |
| 1982265625 | Promise Home Care Agency LLC | In Home Supportive Care | 315 Bahamas Ave, Tampa, FL 33617 | 2019-06-24 |
| 1164912754 | Superior Physician Group | Pain Medicine | 10730 N 56th St Ste 209, Temple Terrace, FL 33617 | 2018-05-18 |
| 1346738796 | Advanced Pain Management and Anesthesiology | Clinic/Center | 4209 E. Busch Blvd, Tampa, FL 33617 | 2018-05-01 |
| 1184112427 | Imperial Connections Support Programs, LLC | In Home Supportive Care | 9806 N Connechusett Rd, Tampa, FL 33617 | 2018-04-23 |
| 1609394204 | Erin E Sleeper | Behavior Technician | 418 Belle Claire Ave, Temple Terrace, FL 33617 | 2017-09-03 |
| 1720504293 | Robin A Kelly | Nurse's Aide | 7523 Pitch Pine Circle, Apt B, Tampa, FL 33617 | 2017-08-16 |
| 1174046023 | Rishita Amish Patel | Pharmacist | 532 Heritage Brook Cir, Apt #101, Temple Terrace, FL 33617 | 2017-07-24 |
| Find all providers in zip 33617 | ||||
| Taxonomy Code | 376K00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Nurse's Aide |
| (1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work. |
| Notes: Source: (1) American Nurses Association, Registered Professional Nurses and Unlicensed Personnel, 2nd ed., 1996; (2) 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 |
|---|---|---|---|---|
| 1154942472 | Brittany Lamattina | Nurse's Aide | 17106 Carrington Park Dr Apt 617, Tampa, FL 33647-2627 | 2020-04-27 |
| 1225691876 | Maydolvis Campos Villalon | Nurse's Aide | 12839n Coverdale Dr, Tampa, FL 33624-4000 | 2019-04-18 |
| 1447710009 | Katina Hayes | Nurse's Aide | 366 Windwood Oaks Dr Apt 202, Tampa, FL 33613-2079 | 2019-03-20 |
| 1770059982 | Luisa Katerine Sotomayor Chacon | Nurse's Aide | 7333 Canal Blvd, Tampa, FL 33615-5601 | 2018-10-16 |
| 1386135234 | Tracy Lynell Plair | Nurse's Aide | 5130 Palm Park Ct Unit 206, Tampa, FL 33610-4053 | 2018-05-27 |
| 1720504293 | Robin A Kelly | Nurse's Aide | 7523 Pitch Pine Circle, Apt B, Tampa, FL 33617 | 2017-08-16 |
| 1346792884 | Jeffrey Paul Myers | Nurse's Aide | 711 W Debbie Cir, Tampa, FL 33613-3310 | 2016-11-01 |
| 1568843746 | Mauirce Harden | Nurse's Aide | 320 W Fletcher Ave, Tampa, FL 33612-3400 | 2015-06-14 |
| 1417233743 | Jimmy Lee Eaves | Nurse's Aide | 12771 Palmer Cir, Tampa, FL 33612-2500 | 2011-11-01 |
| 1225318157 | Selena Jimmieko Cobb | Nurse's Aide | 1124 Andrew Aviles Cir, Tampa, FL 33619-5006 | 2011-08-23 |
| Find all providers in TAMPA | ||||
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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.