KATHERINE MARIE WALLACE (NPI# 1548650617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548650617 |
Entity Type | Individual |
Full Name | KATHERINE MARIE WALLACE |
Other Name | KATHERINE MARIE HORNE |
Credential | NP-C |
Practice Address |
118 Enterprise Ct Ste B Columbus GA 31904-9228 |
Mailing Address |
2702 Betchet Lane Opelika AL 36801-6153 |
Practice Telephone | 7063301389 |
Practice Fax Number | 7063301392 |
Mailing Telephone | 3347501421 |
Enumeration Date | 2015-01-28 |
Last Update Date | 2018-01-23 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
A0714020 | AL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN243697 | GA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 003161276B | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932734886 | Katherine Abigail Wallace | Registered Nurse | 43 Cottage St, Milbridge, ME 04658-3534 | 2020-03-10 |
1942583893 | Katherine Sue Wallace | Counselor | 408 S Gideon Ave, Gideon, MO 63848-9200 | 2011-09-27 |
1801385349 | Katherine H Wallace | Social Worker | 600 Jackson St, Fredericksburg, VA 22401-5719 | 2018-05-09 |
1891190831 | Katherine Lucas Wallace | Marriage & Family Therapist | 3800 Coolidge Ave, Oakland, CA 94602-3311 | 2014-11-04 |
1124395603 | Katherine J Wallace | Nutritionist | 675 W Washington Ave, Madison, WI 53703-2637 | 2011-11-28 |
1518261312 | Katherine Chandler Wallace | Clinical Nurse Specialist | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2011-01-07 |
1851516371 | Katherine G. Wallace | Marriage & Family Therapist | 147 County Rd, Gorham, ME 04038-1916 | 2007-04-17 |
1750438883 | Katherine Ann Wallace | Physical Therapist | 5901 Roosevelt Way Ne, Suite B, Seattle, WA 98105-2754 | 2007-01-04 |
1790843381 | Katherine Ahn Wallace | Dentist | 7801 Center Ave, Suite 101, Huntington Beach, CA 92647-9110 | 2006-12-05 |
Street Address |
118 ENTERPRISE CT STE B |
City | COLUMBUS |
State | GA |
Zip Code | 31904-9228 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
Find all providers in zip 31904 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891394235 | Lisa Ann Popovich | Nurse Practitioner | 3703 Canon Ridge Pl, Columbus, OH 43230-4010 | 2020-10-17 |
1548812159 | Holly Penix | Nurse Practitioner | 223 Bluewing Ct, Columbus, OH 43235-1490 | 2019-07-13 |
1558840496 | Sheila Parker Strickland | Nurse Practitioner | 7413 Whitesville Rd Ste 700, Columbus, GA 31904-3230 | 2018-08-11 |
1669992822 | Susan Lee Mcfall | Nurse Practitioner | 1258 Grandview Ave Ste A, Columbus, OH 43212-3469 | 2017-06-20 |
1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
1285095802 | Laura Aumiller | Nurse Practitioner | 842 Grandview Ave, Columbus, OH 43215-1124 | 2016-03-09 |
1457741498 | Roshann Palmer | Nurse Practitioner | 5151 Reed Rd Ste 205, Columbus, OH 43220-2553 | 2015-01-29 |
1144637299 | Jody Anne Howell | Nurse Practitioner | 1391 W 5th Ave, Suite 260, Columbus, OH 43212-2902 | 2014-07-21 |
1538589536 | Courtney Dubois Shihabuddin | Nurse Practitioner | 750 E Long St Ste 3000, Columbus, OH 43203-1874 | 2014-04-17 |
1871832550 | Jennifer Lynn Grant | Nurse Practitioner | 836 Jackson St., Columbus, IN 47201 | 2013-01-31 |
Find all providers in COLUMBUS |
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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.