ASHLEY LYNETTE WALLACE (NPI# 1679133573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679133573 |
| Entity Type | Individual |
| Full Name | ASHLEY LYNETTE WALLACE |
| Other Name | ASHLEY LYNETTE BONE |
| Credential | MSN, APRN, FNP-C, |
| Practice Address |
1400 8th Ave Fort Worth TX 76104-4110 |
| Practice Telephone | 8179224630 |
| Mailing Telephone | 8179224630 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP141896 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
PENDING | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS BOARD OF NURSING | AP141896 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639669757 | Ashley Wallace | Massage Therapist | 106 Lake Boone Trl Ste B, Raleigh, NC 27608-1052 | 2018-05-14 |
| 1861895203 | Ashley Wallace | Licensed Practical Nurse | 29615 Hanover Blvd, Westland, MI 48186-5179 | 2014-09-30 |
| 1548410863 | Ashley Smith Wallace | Nurse Practitioner | Duke University Hospital South, 200 Trent Drive-clinic 2d, Durham, NC 27710-0001 | 2008-09-23 |
| 1912552035 | Ashley Wailes Wallace | Physical Therapist | 3292 E Willow St, Signal Hill, CA 90755-2309 | 2019-08-06 |
| 1972070068 | Ashley Lynne Wallace | Occupational Therapy Assistant | 1000 Us Highway 82 E, Sherman, TX 75090-1704 | 2018-10-27 |
| 1194227744 | Ashley L Wallace | Registered Nurse | 8801 S 101st East Ave, Tulsa, OK 74133 | 2018-02-28 |
| 1942719612 | Ashley Wallace | Peer Specialist | 1219 K St Nw, Ardmore, OK 73401-1801 | 2017-09-26 |
| 1417466236 | Ashley Wallace | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2017-09-25 |
| 1770951394 | Ashley Kathleen Wallace | Behavioral Analyst | 11 Huron Dr, Natick, MA 01760-1336 | 2015-09-14 |
| 1699157099 | Ashley Wallace | Social Worker | 425 Broadway St, Paducah, KY 42001-0713 | 2015-06-22 |
| Street Address |
1400 8TH AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393674 | Todd Ryan Newton | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-10-13 |
| 1477163749 | Sarah Louise Kelley | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-08-03 |
| 1659980811 | Jessica Marie Custance | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-07-23 |
| 1912516170 | Kevin Pannell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-07-23 |
| 1093336570 | Lindsay Keller Chapman | Physical Therapist | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-05-06 |
| 1093336752 | Joab Odhiambo Acholla | Nurse Practitioner | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-05-04 |
| 1952937823 | Melissa Maxwell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-03-22 |
| 1700419421 | Jaclyn Theresa Channell | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-02-20 |
| 1245861160 | Landon Collier | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-01-29 |
| 1245861178 | Brittney Long | Registered Nurse | 1400 8th Ave, Fort Worth, TX 76104-4110 | 2020-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104430651 | Amanda Raye Juarez | Nurse Practitioner | 1500 Cooper St Fl 2, Fort Worth, TX 76104-2710 | 2020-09-02 |
| 1841800257 | Dorothy L. Osborne | Nurse Practitioner | 6420 Altamesa Blvd Ste 100, Fort Worth, TX 76132-3553 | 2020-08-01 |
| 1972072510 | Peter Karera Ndungi | Nurse Practitioner | 1341 Cattle Crossing Dr, Fort Worth, TX 76131-5333 | 2018-11-13 |
| 1063947117 | Metroplex Integrative Rehabilitation Services | Nurse Practitioner | 4441 Bryant Irvin Rd N., Fort Worth, TX 76107 | 2017-04-26 |
| 1245232297 | Sundie Wright Ellis | Nurse Practitioner | 10717 Lipan Trl, Fort Worth, TX 76108-6924 | 2005-06-02 |
| 1578179636 | Lisa Guerra | Nurse Practitioner | 750 8th Ave Ste 200, Fort Worth, TX 76104-2500 | 2020-09-23 |
| 1871109124 | Caitlyn R Praytor | Nurse Practitioner | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2020-09-22 |
| 1386281871 | Emily Susan Larkin | Nurse Practitioner | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2019-12-04 |
| 1295371037 | Katelyn M Okaro | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2019-11-26 |
| 1174166573 | Caroline W Sims | Nurse Practitioner | 1401 W Pulaski St, Fort Worth, TX 76104-2717 | 2019-10-18 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
Please comment or provide details below to improve the information on ASHLEY LYNETTE 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.