REBECCA WALLACE (NPI# 1104810134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104810134 |
| Entity Type | Individual |
| Full Name | REBECCA WALLACE |
| Credential | APRN |
| Practice Address |
3838 S 700 E Suite 200 Salt Lake City UT 84106-1466 |
| Mailing Address |
1837 Hollywood Ave Salt Lake City UT 84108-3103 |
| Practice Telephone | 8012614988 |
| Practice Fax Number | 8012699427 |
| Mailing Telephone | 8014874160 |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2008-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
216162-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | D1948 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285980250 | Rebecca Wallace | Licensed Practical Nurse | 12 Demarest Rd, Chestnut Ridge, NY 10977-6517 | 2012-07-27 |
| 1295907079 | Rebecca C Wallace | Acupuncturist | The Well for Integrative Medicine, 114 Main Street, Gloucester, MA 01930 | 2008-04-01 |
| 1902941230 | Rebecca H. Wallace | Registered Nurse | 300 W Mcmurray Blvd, Casa Grande, AZ 85222-3327 | 2007-02-21 |
| 1619050630 | Rebecca Wallace | Occupational Therapist | 1025 Brevard Rd Ste 10, Asheville, NC 28806-8563 | 2006-10-23 |
| 1417564477 | Rebecca Wallace | Counselor | 207 Peach Way, Columbia, MO 65203-4905 | 2020-09-24 |
| 1033765896 | Rebecca Kay Wallace | Counselor | 1032 Crosswinds Ct, Wentzville, MO 63385-4836 | 2019-08-16 |
| 1649745027 | Rebecca Wallace | Behavior Technician | 17595 Almahurst St Ste 100a, City of Industry, CA 91748-1792 | 2018-10-11 |
| 1114472735 | Rebecca M Wallace | Psychologist | 1200 Childrens Ave, Ste 12400, Oklahoma City, OK 73104-4637 | 2016-08-24 |
| 1215243043 | Rebecca Ann Wallace | Social Worker | 4950 Memorial Dr, Houston, TX 77007-7440 | 2010-08-31 |
| 1710156765 | Rebecca Hagood Wallace | Physical Therapist | 405 S Seminole Ave, Minneola, FL 34715-5520 | 2008-02-25 |
| Street Address |
3838 S 700 E SUITE 200 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84106-1466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578561072 | Arun V Bidwai | Anesthesiology | 3838 S 700 E, Salt Lake City, UT 84106-1496 | 2005-07-08 |
| 1720527245 | Helen Powell | Nurse Practitioner | 3838 S 700 E, Ste 100, Salt Lake City, UT 84106-1466 | 2017-02-16 |
| 1851840706 | Paula Weaver | Physician Assistant | 3838 S 700 E, Salt Lake City, UT 84106-1466 | 2016-10-03 |
| 1346644135 | Deborah Hatch | Physician Assistant | 3838 S 700 E, Suite 100, Salt Lake City, UT 84106-1466 | 2014-10-22 |
| 1770836397 | Scott William Hadfield | Physician Assistant | 3838 S 700 E, Suite 300a, Salt Lake City, UT 84106-1466 | 2012-10-19 |
| 1417253907 | Omega Interventional Pain Pllc | Anesthesiology | 3838 S 700 E, Ste 300, Salt Lake City, UT 84106-1466 | 2011-02-01 |
| 1336442680 | Anita Mcdonald | Nurse Practitioner | 3838 S 700 E, Ste 100, Salt Lake City, UT 84106-1466 | 2010-12-08 |
| 1548599814 | Shauna Olsen | Nurse Practitioner | 3838 S 700 E, Suite 100, Salt Lake City, UT 84106-1466 | 2009-12-16 |
| 1376773556 | Kristin Elizabeth Barber | Nurse Practitioner | 3838 S 700 E, Suite 100, Salt Lake City, UT 84106-1466 | 2009-07-21 |
| 1164666327 | Keri Lynn Fakata | Pharmacist | 3838 S 700 E, Suite 200, Salt Lake City, UT 84106-1466 | 2009-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801400015 | Tyra Mae Vance | Counselor | 3375 S 880 E, Salt Lake City, UT 84106 | 2020-09-04 |
| 1316596554 | Adam Davies | Pharmacist | 1280 E Stringham Ave., Salt Lake City, UT 84106 | 2019-09-10 |
| 1558919142 | University of Utah | Pharmacy | 1280 E. Stringham Ave, Suite 101, Salt Lake City, UT 84106 | 2019-08-28 |
| 1588174064 | Aaron Potts | Naturopath | 1945 1100 E, #100, Salt Lake City, UT 84106 | 2017-10-10 |
| 1801335005 | Gretchen Dennison | Nurse Practitioner | 2138 S Highland Dr, Salt Lake City, UT 84106 | 2017-02-21 |
| 1376095794 | Jeannette Daneals | Naturopath | 1945 South 1100 East, Suite 100, Salt Lake City, UT 84106 | 2016-11-02 |
| 1073908703 | Tracey Steinmetz | Massage Therapist | 3300 South 970 East, Suite 7, Salt Lake City, UT 84106 | 2015-03-31 |
| 1275949091 | Amy Deforest Edwards | Counselor | Jewish Family Service, 1111 E Brickyard Rd, Suite 218, Slc, UT 84106 | 2014-07-02 |
| 1194138636 | Hillary Lowe Taggart | Nurse Practitioner | 3369 S Highland Dr, Salt Lake City, UT 84106 | 2014-06-03 |
| 1487086617 | Herald R. Clark, Dds | Dentist | 3643 S. Highland Drive, Salt Lake City, UT 84106 | 2013-07-30 |
| Find all providers in zip 84106 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
| 1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
| 1568075604 | Michelle L Davis | Nurse Practitioner | 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 | 2020-08-28 |
| 1518583988 | Melanie Elise Harris | Nurse Practitioner | 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 | 2020-06-22 |
| 1295359651 | Julie Nielsen | Nurse Practitioner | 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 | 2020-06-02 |
| 1770112138 | Justin Henderson | Nurse Practitioner | 3851 S Birch Dr, Salt Lake City, UT 84109-3742 | 2020-04-07 |
| 1346885845 | Anita Hui Lucente | Nurse Practitioner | 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 | 2019-11-08 |
| 1841844057 | Mayra Ibeth Vences | Nurse Practitioner | 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 | 2019-07-25 |
| 1710549928 | Jenny Farley Mason | Nurse Practitioner | 4179 S Monarch Way, Salt Lake City, UT 84124-3168 | 2019-07-08 |
| 1144889940 | Amy Jackson Gilbert | Nurse Practitioner | 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 | 2019-06-06 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84106 |
Please comment or provide details below to improve the information on REBECCA 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.