MS. PATRICIA BONNER WALLACE


Address: 823 Evans St, Greenville, NC 27834-3267
Phone: 2527584400

MS. PATRICIA BONNER WALLACE (NPI# 1033393780) 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) 1033393780
Entity Type Individual
Full Name MS. PATRICIA BONNER WALLACE
Credential MN, APRN, BC
Practice Address 823 Evans St
Greenville
NC 27834-3267
Mailing Address Po Box 8429
Greenville
NC 27835-8429
Practice Telephone 2527584400
Practice Fax Number 2527524197
Mailing Telephone 2527584400
Mailing Fax Number 2527524197
Enumeration Date 2007-12-18
Last Update Date 2008-04-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
45499 NC Behavioral Health & Social Service Providers

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1447553300 Patricia A Wallace Counselor 450 Rosewood Ave, Suite215, Camarillo, CA 93010-5914 2010-12-15
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1174771281 Patricia M Wallace Acupuncturist 217 1st St, Neptune Beach, FL 32266-6145 2008-09-03
1861605719 Patricia Wallace Psychologist 16000 W 9 Mile Rd, Suite 615, Southfield, MI 48075-4808 2007-05-08

Office Location

Street Address 823 EVANS ST
City GREENVILLE
State NC
Zip Code 27834-3267

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NPI Name Taxonomy Address Enumeration
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NPI Name Taxonomy Address Enumeration
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1861038606 Southern Surgical Outpatient Surgery Center, Pa Clinic/Center 2457 Emerald Place, Greenville, NC 27834 2019-11-26
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City GREENVILLE
Zip Code 27834

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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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