MS. KENDA JOLEEN WALLACE (NPI# 1316007339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316007339 |
| Entity Type | Individual |
| Full Name | MS. KENDA JOLEEN WALLACE |
| Credential | RN |
| Practice Address |
4212 North 16th St Phoenix AZ 85016 |
| Mailing Address |
Po Box 31001-0698 Pasadena CA 91110-0698 |
| Practice Telephone | 6022631511 |
| Practice Fax Number | 6022631619 |
| Mailing Telephone | 6022631511 |
| Mailing Fax Number | 6022631619 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WI0600X |
Registered Nurse Specialization: Infection Control |
E42490 | CT | Nursing Service Providers |
| Street Address |
4212 NORTH 16TH ST, |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 163WI0600X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Infection Control |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134289572 | Deanne Marie Millkamp | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083172332 | Howard Blair Watson Jr. | Registered Nurse | Highway 86 and Main, Sells, AZ 85634-0548 | 2019-03-06 |
| 1487814927 | Deborah Ann Farrell | Registered Nurse | 167 N Main Street, Tuba City, AZ 86045-0600 | 2008-06-09 |
| 1639384886 | Nola Jean Naha | Registered Nurse | Hwy 264 Mile Marker 388, Polacca, AZ 86042-4000 | 2007-05-11 |
| 1275638454 | Elizabeth Bradley Graham | Registered Nurse | 3601 S 6th Ave, Mail Code 1-111, Tucson, AZ 85723-0001 | 2006-09-13 |
Please comment or provide details below to improve the information on MS. KENDA JOLEEN 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.