Laurie Ann Wallace (NPI# 1033542170, PAC ID# 5092943472) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1033542170 |
| PAC ID by PECOS | 5092943472 |
| Professional Enrollment ID | I20140109001034 |
| Full Name | Laurie Ann Wallace |
| Organization Legal Name | CHRIST HOSPITAL MEDICAL ASSOCIATES, II LLC |
| Address |
2156 Chamber Ctr Dr Lakeside Park KY 41017-1669 |
| Phone Number | 8593416255 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7012197619 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 360163 | CHRIST HOSPITAL |
| 180035 | ST ELIZABETH EDGEWOOD |
| Address | Phone | Organization |
|---|---|---|
| 2156 Chamber Ctr Dr, Lakeside Park, KY 41017-1669 | 8593416255 | CHRIST HOSPITAL MEDICAL ASSOCIATES, II LLC |
| Organization Legal Name | CHRIST HOSPITAL MEDICAL ASSOCIATES, II LLC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica K Sullivan | Family Medicine | Christ Hospital Medical Associates, II LLC | 2156 Chamber Ctr Dr, Lakeside Park, KY 41017-1669 |
| Jerry L Tolbert | Family Medicine | Christ Hospital Medical Associates, II LLC | 1838 Florence Pike B, Burlington, KY 41005-1838 |
| Marguerite C Schabell | Family Medicine | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Sheena Boury | Family Medicine | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Kari Lynn Boswell | Nurse Practitioner | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Avanti Jakatdar | Internal Medicine | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Rebecca L Tackett | Nurse Practitioner | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Gerry L Tolbert | Family Medicine | Christ Hospital Medical Associates, II LLC | 1838 Florence Pike B, Burlington, KY 41005-1838 |
| Maria Fister Burton | Family Medicine | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Laura G Powers | Nurse Practitioner | Christ Hospital Medical Associates, II LLC | 1955 Dixie Hwy, Suite D, Fort Wright, KY 41011-2882 |
| Street Address |
2156 CHAMBER CTR DR |
| City | LAKESIDE PARK |
| State | KY |
| Zip | 41017-1669 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica K Sullivan | Family Medicine | Christ Hospital Medical Associates, II LLC | 2156 Chamber Ctr Dr, Lakeside Park, KY 41017-1669 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Latasha M Swafford | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Erina T Emerson | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Dawna M Kennedy | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Kelly Reitzes | Optometry | Wing Eyecare, Inc. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Paul T Bertram | Optometry | Bertram Eyecare, P.s.c. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Jamie Daniels Bertram | Optometry | Bertram Eyecare, P.s.c. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Gena Grigson | Clinical Social Worker | 2521 Anderson Rd A, Crescent Springs, KY 41017-1521 | |
| Geraldine E Elliott | Clinical Social Worker | 2521 Anderson Rd A, Crescent Springs, KY 41017-1521 | |
| Merle C Helgeson | Chiropractic | 570 Buttermilk Pike, Crescent Springs, KY 41017-1635 | |
| Anna N Maxey | Family Practice | Mills Medical Practices, LLC | 2114 Chamber Ctr Dr, Lakeside Park, KY 41017-1669 |
| Find all physicians in zip 41017 | |||
| City | LAKESIDE PARK |
| Zip Code | 41017 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LAKESIDE PARK + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Laurie Ann Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.