LISA M. WALLACE (NPI# 1235637182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235637182 |
| Entity Type | Individual |
| Full Name | LISA M. WALLACE |
| Credential | FNP |
| Practice Address |
800 E Cheves St Ste 200 Florence SC 29506-2651 |
| Mailing Address |
Po Box 3239 Florence SC 29502-3239 |
| Practice Telephone | 8436621502 |
| Practice Fax Number | 8436783611 |
| Mailing Telephone | 8437777098 |
| Mailing Fax Number | 8437777102 |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21595 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396368064 | Lisa Jean Wallace | Occupational Therapy Assistant | 480 Somerset St Unit 1, North Plainfield, NJ 07060-4018 | 2020-05-28 |
| 1336779925 | Lisa Wallace | Counselor | 2769 Iris Ave Ste 107, Boulder, CO 80304-4405 | 2020-01-22 |
| 1710521968 | Lisa Anne Wallace | Counselor | 418 Barr Rd, Lexington, SC 29072-2363 | 2019-10-31 |
| 1598225930 | Lisa Buckner Wallace | Counselor | 3750 N Center St, Hickory, NC 28601-8089 | 2019-03-21 |
| 1134575475 | Lisa Wallace | Counselor | 14 Farmer Rd, Milton, MA 02186-3743 | 2016-05-05 |
| 1720476641 | Lisa Wallace | Registered Nurse | 7601 Hospital Dr Ste 202, Sacramento, CA 95823-5408 | 2014-12-30 |
| 1134438286 | Lisa M Wallace | Nurse Practitioner | 831 N Theatre Drive, Marion, IN 46952-1701 | 2010-10-06 |
| 1124002571 | Lisa M Wallace | Counselor | 1807 Capitol Ave, Suite 101 A, Cheyenne, WY 82001-4544 | 2005-11-30 |
| 1003423658 | Lisa Carol Wallace | Nurse Practitioner | 2418 180th St, Allerton, IA 50008-8715 | 2020-09-28 |
| 1992368872 | Lisa Wallace | Licensed Practical Nurse | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2019-04-17 |
| Street Address |
800 E CHEVES ST STE 200 |
| City | FLORENCE |
| State | SC |
| Zip Code | 29506-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871001693 | Med Way Ambulance Service, LLC | Ambulance | 1627 E Palmetto St, Florence, SC 29506 | 2018-01-15 |
| 1851810261 | Daijavon Jaquita Mccall | Specialist/Technologist | 1207 Malloy Street, Florence, SC 29506 | 2017-09-18 |
| 1629453873 | Rebecca Diboni | Pharmacist | 501 E Cheves St, Suite D, Florence, SC 29506 | 2015-07-29 |
| 1710365846 | Tiffany Joann Williams | Counselor | 205 Pearl Cir Florence, Sc, SC 29506 | 2015-05-08 |
| 1275925091 | Joe Brice Williamson Jr. | Pharmacist | 501 E. Cheves St., Suite D, Florence, SC 29506 | 2015-03-03 |
| 1528474632 | La'keisha Coker | Dietitian, Registered | 145 E. Cheves St., Florence County Health Department, Florence, SC 29506 | 2014-07-09 |
| 1275948085 | Patrick Kevin Mccarthy | Dietitian, Registered | 145 East Cheves Street, Florence County Health Dept., Florence, SC 29506 | 2014-07-01 |
| 1073931655 | Gwen A Davis | Registered Nurse | 145 E Cheves Street, Sc Dhec Pee Dee Region, Florence, SC 29506 | 2014-04-01 |
| 1205267879 | Jessica Turner | Physical Therapist | 555 E Cheves St., Inpatient Rehab Department, Florence, SC 29506 | 2013-12-09 |
| 1700213923 | Pamela Orange | Nurse's Aide | 2501 Sparklberry Lane, Florence, SC 29506 | 2013-10-02 |
| Find all providers in zip 29506 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093322703 | Stephenie Matthews Gordon | Nurse Practitioner | 3037 Waterford Dr, Florence, SC 29501-6383 | 2020-09-26 |
| 1073130829 | Lindsay Humphreys | Nurse Practitioner | 309 Ashwoody Dr, Florence, AL 35633-1700 | 2020-06-28 |
| 1710504568 | Deborah Valentine | Nurse Practitioner | 9331 Highway 157, Florence, AL 35633-4635 | 2020-06-28 |
| 1235755984 | Chasidy Lynn Ward | Nurse Practitioner | 406 Woodland Dr, Florence, SC 29501-5445 | 2020-06-18 |
| 1174146054 | Heather Helmbrecht-vines | Nurse Practitioner | 1631 Corinthian Dr Apt 2023, Florence, KY 41042-7424 | 2020-05-26 |
| 1245850148 | Duran Healthcare Pllc | Nurse Practitioner | 9910 Berberich Dr Unit E, Florence, KY 41042-3220 | 2020-04-21 |
| 1548897788 | Pansi Anil Patel | Nurse Practitioner | 511 Prestwick Dr, Florence, SC 29501-8738 | 2020-03-26 |
| 1245861228 | Chasity Beene | Nurse Practitioner | 2929 Cloverdale Rd Unit D, Florence, AL 35633-1505 | 2020-01-29 |
| 1023649191 | Loreena Ruth Fraboni | Nurse Practitioner | 5880 Co-67, Florence, CO 81226 | 2020-01-28 |
| 1093355430 | Stephen Panosian | Nurse Practitioner | 2612 N Palo Verde Dr, Florence, AZ 85132-6880 | 2020-01-14 |
| Find all providers in FLORENCE | ||||
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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.