MRS. TRACEE MARIE WALLACE (NPI# 1811128010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811128010 |
Entity Type | Individual |
Full Name | MRS. TRACEE MARIE WALLACE |
Other Name | MS. TRACEE MARIE HERMANSON |
Credential | PA-C |
Practice Address |
5255 Loughboro Rd Nw Washington DC 20016-2633 |
Mailing Address |
5805 Edson Ln Rockville MD 20852-2925 |
Practice Telephone | 2025374000 |
Mailing Telephone | 5055731388 |
Enumeration Date | 2009-08-05 |
Last Update Date | 2017-03-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA031280 | DC | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679182539 | Tracee Wallace | Assistant Behavior Analyst | 963 Texas St, Mobile, AL 36604-3148 | 2020-07-27 |
Street Address |
5255 LOUGHBORO RD NW |
City | WASHINGTON |
State | DC |
Zip Code | 20016-2633 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013910884 | Lawrence D Ramunno | Family Medicine | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2005-05-24 |
1164023701 | Elizabeth Louise Echols | Registered Nurse | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-11-02 |
1932715364 | Ifeyinwa Nwokike | Nurse Practitioner | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-09-21 |
1881209286 | Shahane Everett | Registered Nurse | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-09-11 |
1104431048 | Julie Butchart | Nurse Practitioner | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-09-08 |
1609493758 | Debra Mims | Doula | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-07-05 |
1982226254 | Ikenna L Unegbu | Pharmacist | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-05-10 |
1871122713 | Valentina Wigozki | Physician Assistant | 5255 Loughboro Rd Nw, Washington, DC 20016 | 2020-04-03 |
1306470166 | Jaylon Garrett | Nurse Practitioner | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-03-02 |
1639719404 | Natalie Shepherd | Nurse Practitioner | 5255 Loughboro Rd Nw, Washington, DC 20016-2633 | 2020-01-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790390144 | Julie Marcus | Nurse Practitioner | 4200 Wisconsin Avenue Nw, 4th Floor, Washington, DC 20016 | 2020-09-12 |
1669080289 | Rachel Mary Lipman | Student in an Organized Health Care Education/Training Program | 5185 Macarthur Blvd, Washington, DC 20016 | 2020-07-20 |
1285253484 | Shawn Anthony Haupt | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave, 4th Floor, Dept of Pediatrics, Washington, DC 20016 | 2020-04-09 |
1457991176 | Joseph Stephen Driscoll | Specialist/Technologist | St. Albans School / Mount St, Alban, 3001 Wisconsin Ave, Washington, DC 20016 | 2020-01-10 |
1164063293 | Christine Ju | Dietitian, Registered | 3517 Ordway St Nw, Washington, DC 20016 | 2019-09-30 |
1376191072 | Carlitta Theresa Harris | Registered Nurse | 501 School Street Suite, Suite 200, Sw, DC 20016 | 2019-08-27 |
1295399384 | People's Lactation LLC | Registered Nurse | 3022 Wisconsin Ave Nw Apt 208, Washington, DC 20016 | 2019-04-24 |
1578057428 | Itzhak Brook | General Practice | 4431 Albemarle St. Nw, Washington, DC 20016 | 2018-06-14 |
1093211724 | Hannah Elise Sterling | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave Nw 4th Floor, Department of Pediatrics, Washington, DC 20016 | 2018-04-02 |
1447755616 | Michele Elizabeth Zaragoza | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave Nw, 4th Floor, Dept of Pediatrics, Washington, DC 20016 | 2018-03-28 |
Find all providers in zip 20016 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811391022 | Shannon Rasmussen Duescher | Physician Assistant | 3800 Reservoir Rd Nw # 7phc, Washington, DC 20007-2113 | 2014-10-17 |
1356623961 | Denise Nanette Blackbourne | Physician Assistant | 106 Irving St Nw Ste 206, Washington, DC 20010-2993 | 2011-09-09 |
1114056421 | Kevin Joseph Dubree | Physician Assistant | 110 Irving St, Nw, Unit 1f, Room 1218, Washington, DC 20010-2927 | 2007-03-04 |
1225139686 | Kimberly Lynn Seablom | Physician Assistant | 6209 Nebraska Ave Nw, Washington, DC 20015-1144 | 2006-09-26 |
1548232887 | David Barry Jennette | Physician Assistant | 1775 Eye St Nw, Suite 1150, Washington, DC 20006-2402 | 2006-02-02 |
1699301853 | Monica Vu | Physician Assistant | 111 Michigan Ave Nw, Washington, DC 20010-2916 | 2020-03-19 |
1659843803 | Kalley Rae Veit | Physician Assistant | 3800 Reservoir Rd Nw, 1 Gorman, Washington, DC 20007 | 2018-12-28 |
1760961494 | Katie Ann Leemaster | Physician Assistant | 2440 M St Nw Ste 200, Washington, DC 20037-1449 | 2018-08-13 |
1851885313 | Samantha Brooke Bickar | Physician Assistant | 900 23rd St Nw, Washington, DC 20037-2342 | 2018-06-19 |
1265921605 | Meredith Patricia Miles | Physician Assistant | 3800 Reservoir Rd Nw, Washington, DC 20007-2113 | 2018-05-01 |
Find all providers in WASHINGTON |
City | WASHINGTON |
Zip Code | 20016 |
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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.