MRS. BRENDA RENEE WALLACE (NPI# 1912211681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912211681 |
| Entity Type | Individual |
| Full Name | MRS. BRENDA RENEE WALLACE |
| Credential | RN, MSN, ARNP |
| Practice Address |
1406 Rowantree Dr Dover FL 33527-4937 |
| Practice Telephone | 8507669131 |
| Practice Fax Number | 8136513473 |
| Mailing Telephone | 8507669131 |
| Mailing Fax Number | 8136513473 |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2010-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SW0102X |
Clinical Nurse Specialist Specialization: Women's Health |
ARNP 9181213 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104130426 | Brenda Wallace | Physician Assistant | 3142 Horizon Rd Ste 209, Rockwall, TX 75032-7802 | 2010-07-28 |
| 1275703647 | Brenda Janice Wallace | Registered Nurse | 3107 Eastwick Dr, Cleveland Heights, OH 44118-1222 | 2008-03-03 |
| 1457482903 | Brenda Wallace | Speech-Language Pathologist | 712 Girard Blvd Ne, Jefferson Ms, Albuquerque, NM 87106-2714 | 2007-03-08 |
| Street Address |
1406 ROWANTREE DR |
| City | DOVER |
| State | FL |
| Zip Code | 33527-4937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891308052 | Learn 2 Speak LLC | Speech-Language Pathologist | 1505 Ringmore Ct, Dover, FL 33527 | 2020-08-27 |
| 1336570555 | Sarah Jane Connatser | Custodial Care Facility | 14576 Blackjack Rd, Dover, FL 33527 | 2013-12-13 |
| 1417207838 | Rudolf Bigord | Case Manager/Care Coordinator | 1712 Abbey Trace Drive, Tampa, FL 33527 | 2012-09-13 |
| 1689944381 | Walgreens | Health Maintenance Organization | 13213 Shady Stables Lane, Dover, FL 33527 | 2012-01-11 |
| 1376553883 | Suncoast Community Health Center Inc | Pharmacy | 14254 Sr 574 Bvld, Dover, FL 33527 | 2006-08-08 |
| 1144657834 | Barefoot Birth | Midwife | 1319 Sydney Washer Rd, Dover, FL 33527 | 2013-09-26 |
| 1023187424 | Edward Craig Reller | Internal Medicine | 14254 State Road 574, Dover, FL 33527 | 2006-11-07 |
| 1194156489 | Rafael Avecillas | Assisted Living Facility | 2644 Fritzke Rd, Dover, FL 33527-3433 | 2013-12-11 |
| 1669871711 | Christina Trang Nguyen | Pharmacist | 9550 Gallagher Rd, Dover, FL 33527-3604 | 2014-08-14 |
| 1043615693 | Donald Edward Smith | Pharmacist | 9550 Gallagher Rd, Dover, FL 33527-3604 | 2014-10-24 |
| Find all providers in zip 33527 | ||||
| Taxonomy Code | 364SW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679111546 | Teresa Lance | Clinical Nurse Specialist | 83 W Miller St, Orlando, FL 32806-2031 | 2019-12-11 |
| 1194080655 | Rhonda Jo Brockman | Clinical Nurse Specialist | 100 Northpoint Pkwy, West Palm Beach, FL 33407-1906 | 2012-07-11 |
| 1891019063 | Jennifer Ellen Faccioli | Clinical Nurse Specialist | 1425 Creech Rd, Naples, FL 34103-4207 | 2010-03-17 |
| 1407011414 | Roberta Helene Altschuler | Clinical Nurse Specialist | 38754 State Road 80, Belle Glade, FL 33430-5615 | 2008-07-20 |
| 1093902538 | Yara Diane Hatem | Clinical Nurse Specialist | 3100 Coral Hills Dr, Suite 205, Coral Springs, FL 33065-4137 | 2007-09-28 |
| 1811964372 | Carol A Barttrum | Clinical Nurse Specialist | 300 S Main St, Brooksville, FL 34601-3320 | 2006-03-03 |
Please comment or provide details below to improve the information on MRS. BRENDA RENEE 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.