MS. STACEY ANN WALLACE (NPI# 1568839116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568839116 |
| Entity Type | Individual |
| Full Name | MS. STACEY ANN WALLACE |
| Credential | CPHT |
| Practice Address |
3390 West Rd Trenton MI 48183-2323 |
| Practice Telephone | 7346766622 |
| Practice Fax Number | 7346764166 |
| Mailing Telephone | 7346766622 |
| Mailing Fax Number | 7346764166 |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 5303003960 | MI | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700149838 | Stacey Marie Wallace | Specialist | 75 Chestnut St, Fredonia, NY 14063-1630 | 2012-06-22 |
| Street Address |
3390 WEST RD |
| City | TRENTON |
| State | MI |
| Zip Code | 48183-2323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467540492 | James Joseph Giordano | Pharmacist | 3390 West Rd, Trenton, MI 48183-2323 | 2006-10-11 |
| 1518405521 | Lisa Ballog | Pharmacy Technician | 3390 West Rd, Trenton, MI 48183-2323 | 2017-02-09 |
| 1235250887 | Krista Feges | Pharmacist | 3390 West Rd, Trenton, MI 48183-2323 | 2007-04-02 |
| 1063598308 | Richard Grossman | Pharmacist | 3390 West Rd, Trenton, MI 48183-2323 | 2006-10-30 |
| 1720160161 | Rachel Louise Henegar | Pharmacist | 3390 West Rd, Trenton, MI 48183-2323 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043869324 | Tonya Saint Onge | Physical Therapy Assistant | Applewood Nursing Center, 18500 Van Horn Rd., Woodhaven, MI 48183 | 2019-09-09 |
| 1326568635 | Samantha Nicole Steffen | Behavior Technician | 3244 Concord, Trenton, MI 48183 | 2017-06-27 |
| 1225567688 | Nicholas Michael Abdallah | Dentist | 21080 Allen Road, Woodhaven, MI 48183 | 2017-06-08 |
| 1265823041 | Sherry A Dees Lmsw Acsw LLC | Counselor | 23933 Allen Road, Suite 3, Woodhaven, MI 48183 | 2015-02-14 |
| 1720480825 | Marlo Brazier | Technician, Other | 226000 West Rd, Apt 108, Trenton, MI 48183 | 2014-09-19 |
| 1679902597 | Henry Ford Wyandotte Hospital | Dietitian, Registered | 1640 Fort Street, Suite D Attn Denise, Trenton, MI 48183 | 2013-11-02 |
| 1548605116 | Kay Vonne Cason Psy Pllc | Psychologist | 19366 Allen Rd Ste. D, Brownstown, MI 48183 | 2013-05-08 |
| 1891031118 | Mazin K Dds PC | Dentist | 22319 King Rd, Woodhaven, MI 48183 | 2012-12-13 |
| 1114241585 | John Shafer | Psychologist | 1660 Fort St, Trenton, MI 48183 | 2010-03-15 |
| 1982871026 | Anthony G Gray | Physical Therapist | 20059 King Road, Woodhaven, MI 48183 | 2008-05-08 |
| Find all providers in zip 48183 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801418983 | Kelsey Houk | Pharmacy Technician | 932 Mcpherson St, Trenton, MO 64683-2261 | 2020-05-12 |
| 1316224850 | Shirley Carol Gilbert | Pharmacy Technician | 2045 Us Highway 45 Byp S, Trenton, TN 38382-2940 | 2011-11-11 |
| 1518405521 | Lisa Ballog | Pharmacy Technician | 3390 West Rd, Trenton, MI 48183-2323 | 2017-02-09 |
| 1962752287 | Eileen T. Carter | Pharmacy Technician | 1125 Chambers St, Trenton, NJ 08610-5801 | 2012-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023631991 | Mohammad E Salman | Pharmacy Technician | 33280 Richard O Dr, Sterling Hts, MI 48310-6116 | 2020-05-26 |
| 1710443502 | Sherri Ann Brady | Pharmacy Technician | 840 Purdy Rd, Montgomery, MI 49255-9618 | 2019-02-16 |
| 1578039277 | Alexandra A Milantoni | Pharmacy Technician | 22509 Trombly St, Saint Clair Shores, MI 48080-2889 | 2018-10-19 |
| 1912473844 | Adam Mathew King | Pharmacy Technician | 1550 E Beltline Ave Se Ste 175, Grand Rapids, MI 49506-4362 | 2018-10-18 |
| 1225564735 | Ashley Nichole Kochan | Pharmacy Technician | 1001 N Leroy St, Fenton, MI 48430-5308 | 2017-05-03 |
| 1457886848 | Javeria Qamar | Pharmacy Technician | 19173 Red Oak Ln, Brownstown, MI 48193-8804 | 2017-04-24 |
| 1245764356 | Ashly Megan Kronberger | Pharmacy Technician | 312 Atlas St, Gwinn, MI 49841-2823 | 2017-04-14 |
| 1790153831 | Ryan Arthur Silverthorn | Pharmacy Technician | 2874 Tall Oaks Ct, Apt 11, Auburn Hills, MI 48326-4171 | 2015-09-06 |
| 1023485117 | Michelle Ann Anderson | Pharmacy Technician | 9267 Pauline St, Montague, MI 49437-1021 | 2015-08-25 |
| 1861882730 | Alice Mathews | Pharmacy Technician | 7475 Creyts Rd, Dimondale, MI 48821-9416 | 2015-01-30 |
| Find all providers with the same taxonomy | ||||
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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.