AMBER LEIGH WALLACE (NPI# 1043673643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043673643 |
| Entity Type | Individual |
| Full Name | AMBER LEIGH WALLACE |
| Other Name | AMBER LEIGH POLK |
| Credential | LPN |
| Practice Address |
113 Riverside Dr Hart MI 49420-1077 |
| Practice Telephone | 2312204620 |
| Mailing Telephone | 2312204620 |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2016-03-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 4703108739 | MI | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679716534 | Amber Michelle Wallace | Nurse Practitioner | 615 N. Michigan St.- 1st Floor Hospitalist Suite, South Bend, IN 46601-1469 | 2009-04-08 |
| 1427538883 | Amber Wallace | Massage Therapist | 104 5th St, Hood River, OR 97031-2058 | 2018-08-15 |
| 1053847020 | Amber Wallace | Physical Therapist | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2017-05-11 |
| 1043612872 | Amber Leigh Wallace | Social Worker | 11120 Somerset Ave, Princess Anne, MD 21853-2970 | 2014-09-24 |
| 1104035526 | Amber Ann Wallace | Obstetrics & Gynecology | 1686 Skylyn Dr, Suite 101, Spartanburg, SC 29307 | 2007-05-22 |
| Street Address |
113 RIVERSIDE DR |
| City | HART |
| State | MI |
| Zip Code | 49420-1077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891216 | Tina Hodges | Speech-Language Pathologist | 701 East Main, Hart, MI 49420 | 2018-12-03 |
| 1760847115 | Jesse Marie Burke | Social Worker | 300 W Johnson Street, Hart, MI 49420 | 2015-12-29 |
| 1184778649 | Peter Mason | Dentist | 110 Dryden St, Hart, MI 49420 | 2007-01-22 |
| 1477553816 | John P Cooney | Family Medicine | 2481 N 72nd Ave, Hart, MI 49420 | 2005-07-28 |
| 1669418356 | Rudy C Ochs | Family Medicine | 611 E Main St, Hart, MI 49420 | 2006-06-21 |
| 1881646610 | Jennifer L Tate | Physician Assistant | 611 E Main St, Hart, MI 49420 | 2006-05-17 |
| 1902423239 | Hart Family Dentistry Pllc | Dentist | 110 S Dryden St, Hart, MI 49420-1105 | 2020-07-02 |
| 1285659029 | Douglas S. Brown | Chiropractor | 107 E Main St, Hart, MI 49420-1106 | 2006-07-13 |
| 1700364056 | Christina Delgado | Social Worker | 105 Lincoln St, Hart, MI 49420-1112 | 2018-07-30 |
| 1184789174 | Norma Ann Gilbert | Family Medicine | 24 North State Street, Hart, MI 49420-1121 | 2006-12-27 |
| Find all providers in zip 49420 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: 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 |
|---|---|---|---|---|
| 1730789546 | Lashonda S Noble | Licensed Practical Nurse | 21107 Lahser Rd, Southfield, MI 48033-4400 | 2020-10-30 |
| 1841890670 | Danielle Berry | Licensed Practical Nurse | 58 Murray St Se, Grand Rapids, MI 49548-3304 | 2020-10-30 |
| 1053911719 | Margaret Theresa Fry | Licensed Practical Nurse | 4929 Cedarview St Apt 2c, Ypsilanti, MI 48197-5029 | 2020-10-30 |
| 1821697095 | Andrew Onyemaechi Onyeanula | Licensed Practical Nurse | 8281 Woodcrest Dr Apt 2, Westland, MI 48185-1238 | 2020-10-20 |
| 1255948121 | Nikki Leonard | Licensed Practical Nurse | 806 Chartier, Marine City, MI 48039-2319 | 2020-09-25 |
| 1235746033 | Roberta A Thomas | Licensed Practical Nurse | 399 S Union St Apt 15, Sparta, MI 49345-1534 | 2020-09-25 |
| 1821604562 | Wendy Lynne Hughes | Licensed Practical Nurse | 2025 S Washington Ave Suite 210 Lansing, Mi 48910, Lansing, MI 48910 | 2020-09-18 |
| 1043824519 | Linda Hershberger | Licensed Practical Nurse | 219 Lane St, Mendon, MI 49072-9630 | 2020-09-02 |
| 1861006538 | David Bradley | Licensed Practical Nurse | 15540 Prevost St, Detroit, MI 48227-1963 | 2020-09-01 |
| 1215540430 | Sheronda Lanetta Blackmon | Licensed Practical Nurse | 13929 Harper Ave., Detroit, MI 48213 | 2020-08-27 |
| Find all providers with the same taxonomy | ||||
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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.