MRS. SUSAN ANNE WALLACE (NPI# 1477910792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477910792 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN ANNE WALLACE |
| Credential | LPN |
| Practice Address |
44 Beechwood Dr Manorville NY 11949-2947 |
| Practice Telephone | 6319092182 |
| Mailing Telephone | 6319092182 |
| Enumeration Date | 2016-01-16 |
| Last Update Date | 2016-01-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 323868 | NY | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376842732 | Susan Elizabeth Wallace | Dietitian, Registered | 102 Carran Dr, Lakeside Park, KY 41017-2233 | 2011-03-23 |
| 1598904427 | Susan Leigh Wallace | Specialist | 103 Windwood Rd, North Syracuse, NY 13212-1956 | 2009-02-17 |
| 1366646457 | Susan Taylor Wallace | Speech-Language Pathologist | 3409 Connection Dr, Fayetteville, NC 28311-0151 | 2007-06-12 |
| 1952426025 | Susan Wallace | Acupuncturist | 1009 Solano Ave, # A, Albany, CA 94706-1617 | 2007-03-20 |
| 1447375662 | Susan D. Wallace | Counselor | 166 Pawtucket Avenue, Pawtucket, RI 02860-3811 | 2007-03-20 |
| 1639554769 | Susan Wallace | Physical Therapist | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2015-07-30 |
| 1740537687 | Susan R Wallace | Nurse Practitioner | 100 Methodist Blvd, Hattiesburg, MS 39402-1295 | 2012-08-09 |
| 1710247812 | Susan Victoria Wallace | Marriage & Family Therapist | 9685 Hayes St, Riverside, CA 92503-3660 | 2012-05-22 |
| 1427203462 | Susan Marie Wallace | Occupational Therapist | 355 Oak Grove Rd, Spartanburg, SC 29301-2537 | 2008-11-18 |
| 1194985887 | Susan Jean Wallace | Registered Nurse | E Hwy 18, Pine Ridge, SD 57770-1201 | 2008-06-16 |
| Street Address |
44 BEECHWOOD DR |
| City | MANORVILLE |
| State | NY |
| Zip Code | 11949-2947 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992270946 | Bethesda Elite Care Inc | Home Health | 3 Surrey Lane, Manorville, NY 11949 | 2018-10-05 |
| 1922303072 | Samantha Ann Martino | Licensed Practical Nurse | 20 North Street, Manorville, NY 11949 | 2011-01-21 |
| 1336449453 | Eastport South Manor School District | Local Education Agency (LEA) | 543 Moriches Middle Island Rd, Manorville, NY 11949 | 2010-10-22 |
| 1134439599 | Lori M. Franchi | Social Worker | 543 Moriches Middle Island Road, Manorville, NY 11949 | 2010-10-19 |
| 1952556706 | Dawn Marie Munoz | Developmental Therapist | 53 Manorview Way, Manorville, NY 11949 | 2008-11-20 |
| 1770704504 | Ka Lun Benny Chan | Pharmacist | 8 Long Road, Manorville, NY 11949 | 2007-05-01 |
| 1245374560 | Maryhaven Center of Hope Inc. | Intermediate Care Facility, Mentally Retarded | 226 Eastport Manor Road, Manorville, NY 11949 | 2007-02-19 |
| 1891865721 | Independent Group Home Living | Nursing Facility/Intermediate Care Facility | 221 N. Sunrise Service Rd., Manorville, NY 11949 | 2006-11-08 |
| 1639107451 | Robert Galler | Neurological Surgery | 496 County Road 111, Building D, Manorville, NY 11949 | 2006-06-29 |
| 1679981401 | Elizabeth Ann Sanders | Physician Assistant | 496 County Road 111, Building B, Manorville, NY 11949 | 2014-07-24 |
| Find all providers in zip 11949 | ||||
| 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 |
|---|---|---|---|---|
| 1265046817 | Kathryn Angela Barile | Licensed Practical Nurse | 9 Frontier Trl, Manorville, NY 11949-2526 | 2020-09-01 |
| 1699386474 | Juliana Marissa Devito | Licensed Practical Nurse | 537 Wading River Rd, Manorville, NY 11949-3448 | 2020-08-13 |
| 1447876784 | Caroline Hennessy | Licensed Practical Nurse | 2 Bunker Ct, Manorville, NY 11949-2802 | 2020-06-23 |
| 1053803122 | Katherine Mccabe | Licensed Practical Nurse | 59 Cobbleridge Ln, Manorville, NY 11949-2522 | 2018-06-04 |
| 1215489349 | Alexandria Tuminaro | Licensed Practical Nurse | 112 Owls Nest Ct, Manorville, NY 11949-2619 | 2016-10-24 |
| 1497115844 | Stephanie Hayes | Licensed Practical Nurse | 23 Winding Path Apt 18, Manorville, NY 11949-2250 | 2016-02-27 |
| 1346657525 | Dawn Meyer | Licensed Practical Nurse | 5 Crest Hollow Ln, Manorville, NY 11949-3235 | 2014-07-19 |
| 1720401763 | Janice Fitzgibbon | Licensed Practical Nurse | 16 Evelyn Ct, Manorville, NY 11949-2808 | 2014-01-28 |
| 1255754206 | Heather Suzannw Allen-morabito | Licensed Practical Nurse | 6 Cristina Dr, Manorville, NY 11949-3206 | 2014-01-28 |
| 1518398353 | Lynn Laliberte | Licensed Practical Nurse | 21 Long Rd, Manorville, NY 11949-3325 | 2013-12-04 |
| Find all providers in MANORVILLE | ||||
| City | MANORVILLE |
| Zip Code | 11949 |
Please comment or provide details below to improve the information on MRS. SUSAN ANNE 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.