EMILY WALLACE (NPI# 1326680331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326680331 |
| Entity Type | Individual |
| Full Name | EMILY WALLACE |
| Other Name | EMILY LAZZAR |
| Credential | PA-C |
| Practice Address |
1661 Philadelphia Ave Se Grand Rapids MI 49507-2251 |
| Mailing Address |
8101 Fulton St E Ada MI 49301-9100 |
| Practice Telephone | 6164908578 |
| Mailing Telephone | 6164908578 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2020-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013404813 | Emily Wallace | Home Health | 1353 Perkins Dr Apt C5, Wooster, OH 44691-4175 | 2018-04-17 |
| 1306204144 | Emily Brooke Wallace | Pharmacist | 2290 Ne Westwood Dr Apt H103, Pullman, WA 99163-5233 | 2016-02-08 |
| 1548600711 | Emily Sarah Wallace | Physical Therapist | 800 East Gate Blvd, Garden City, NY 11530-2104 | 2013-07-02 |
| 1902457120 | Emily Anne Wallace | Nurse Practitioner | 401 Oakwood Blvd, Round Rock, TX 78681-4067 | 2019-09-28 |
| 1881163798 | Emily Wallace | Occupational Therapist | 1445 E 10th St, Cookeville, TN 38501-2017 | 2018-11-20 |
| 1548748643 | Emily R Wallace | Registered Nurse | 33 W Main St, Albion, IL 62806-1006 | 2018-07-31 |
| 1467962308 | Emily Kay Wallace | Specialist/Technologist | 208 Edgemont Blvd, Alamosa, CO 81101-2320 | 2017-10-05 |
| 1669900296 | Emily Horne Wallace | Nurse Practitioner | 420 Thomson Cir, Abbeville, SC 29620-5656 | 2017-05-26 |
| 1609278613 | Emily Wallace | Occupational Therapist | 1625 S Main St, Malvern, AR 72104-5600 | 2014-09-22 |
| 1659706240 | Emily Marie Wallace | Counselor | 119 Russell Street, New England Center for Mental Health, Littleton, MA 01460-3076 | 2013-09-13 |
| Street Address |
1661 PHILADELPHIA AVE SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49507-2251 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487156956 | Kristen Zvirbulis Keeter | Physical Therapist | 625 Kenmoor Ave. Se Ste 306, Grand Rapids, MI 49507 | 2018-03-01 |
| 1508371758 | Vanessa Woodard | Case Manager/Care Coordinator | 1939 S. Division Ave., Grand Rapids, MI 49507 | 2017-12-11 |
| 1306350624 | Courtney Nicole Porter | Social Worker | 1979 S Division Ave., Grand Rapids, MI 49507 | 2017-11-22 |
| 1518496900 | 733 Prince LLC | Custodial Care Facility | 733 Prince St Se, Grand Rapids, MI 49507 | 2017-06-08 |
| 1720515406 | Tiffanie Ryder | Massage Therapist | 1110 Merrified St, Grand Rapids, MI 49507 | 2017-05-12 |
| 1619404308 | Shedrice's Afc | Respite Care | 246 Powell Se Ave, Grand Rapids, MI 49507 | 2017-05-12 |
| 1992171748 | Richard Lavell Flowers | Non-emergency Medical Transport (VAN) | 1447 Elliott, Grand Rapids, MI 49507 | 2015-08-17 |
| 1982096087 | Jordana Seebeck | Social Worker | 1939 S. Division Se, Grand Rapids, MI 49507 | 2015-02-26 |
| 1083973135 | Carla May Waite | Social Worker | 1939 South Division, Grand Rapids, MI 49507 | 2012-05-10 |
| 1740550037 | Jamie Lee Dalton | Social Worker | 2017 College Ave Se, Grand Rapids, MI 49507 | 2012-01-04 |
| Find all providers in zip 49507 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473198 | Rachel M. Graziano | Physician Assistant | 18 Lowell Ave Ne, Grand Rapids, MI 49503-3760 | 2020-10-07 |
| 1811537269 | Joseph Salvatore Giovannucci | Physician Assistant | 145 Michigan St Ne Ste 2230, Grand Rapids, MI 49503-2562 | 2020-01-14 |
| 1326685686 | Mitchell Lebel | Physician Assistant | 932 Fulton St E Unit 1, Grand Rapids, MI 49503-3565 | 2019-12-05 |
| 1124688197 | Leeann Marie Kuehn | Physician Assistant | 218 Warren Ave Se, Grand Rapids, MI 49506-1582 | 2019-06-20 |
| 1770057549 | Shelby Elizabeth Hunt | Physician Assistant | 100 Michigan St Ne # Mc9017, Grand Rapids, MI 49503-2560 | 2019-01-15 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1174029094 | Katrina Ann Brummel | Physician Assistant | 555 Midtowne St Ne Ste 110, Grand Rapids, MI 49503-5731 | 2018-03-30 |
| 1902312994 | Aaron Michaud | Physician Assistant | 301 Barclay Ave Ne, Grand Rapids, MI 49503 | 2017-12-28 |
| 1538687215 | Sonia Nicola | Physician Assistant | 4100 Embassy Dr Se Ste 400, Grand Rapids, MI 49546-2416 | 2017-09-01 |
| 1437679487 | Kelly Mcgillicuddy | Physician Assistant | 100 Michigan St, Suite A721 Mc127, Grand Rapids, MI 49503 | 2017-06-21 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49507 |
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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.