JOSEPH JELKS WALLACE (NPI# 1891275095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891275095 |
| Entity Type | Individual |
| Full Name | JOSEPH JELKS WALLACE |
| Practice Address |
23361 Ferndale Ave Punta Gorda FL 33980-4814 |
| Practice Telephone | 2392818121 |
| Mailing Telephone | 2392818121 |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
866612 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235785437 | Joseph Derrick Wallace | Pharmacist | 5960 Highway 105, Beaumont, TX 77708-3700 | 2019-08-13 |
| 1912419201 | Joseph Eric Wallace | Counselor | 237 26th St, Ogden, UT 84401 | 2017-10-26 |
| 1255699898 | Joseph C. Wallace | Case Manager/Care Coordinator | 58923 Business Center Dr, Suite C, D, & E, Yucca Valley, CA 92284-7311 | 2012-05-02 |
| 1629360268 | Joseph Wallace | Rehabilitation Practitioner | 100 Rosaschi Rd, Yerington, NV 89447-8722 | 2011-05-13 |
| 1790839728 | Joseph Patrick Wallace Jr. | Psychologist | 44 North Street, Danbury, CT 06810 | 2007-01-23 |
| 1255421012 | Joseph Francis Wallace IIi | Dentist | 23 Maple Ave, Greenwich, CT 06830-5620 | 2006-10-13 |
| 1104850957 | Joseph Claude Wallace | Surgery | 1031 Fairfax Park, Tuscaloosa, AL 35406-2807 | 2006-07-10 |
| Street Address |
23361 FERNDALE AVE |
| City | PUNTA GORDA |
| State | FL |
| Zip Code | 33980-4814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144699646 | Raymond B Hendricks | Custodial Care Facility | 1306 Annette St, Port Charlotte, FL 33980 | 2015-09-15 |
| 1649616517 | Anne Yvonne Clarke | Nurse's Aide | 3378 Idlewild Street, Port Charlotte, FL 33980 | 2013-05-17 |
| 1427395680 | John F Guarino Md Pa | Surgery | 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980 | 2013-01-08 |
| 1497049027 | Patricia Ann Drow | Occupational Therapist | 24469 Manchester Trail, Port Charlotte, FL 33980 | 2011-05-31 |
| 1811221484 | Amanda K Huffman | Clinical Nurse Specialist | 22655 Bayshore Rd Ste 130, Port Charlotte, FL 33980 | 2009-09-29 |
| 1093967739 | Donna Olson | Nurse Practitioner | 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2008-10-14 |
| 1821278029 | Paula Marie Allison | Dietitian, Registered | 23422 Burlingame Ave, Port Charlotte, FL 33980 | 2007-11-06 |
| 1689865891 | Keith Anthony Williams | Physical Medicine & Rehabilitation | 4265 Laura Street, Port Charlotte, FL 33980 | 2007-08-05 |
| 1578685491 | Richard Michael Cocchieri | Dentist | Florida Department of Health In Charlotte County, 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2007-04-03 |
| 1417989328 | John F Guarino | Surgery | 4245 Kings Highway, Unit A, Port Charlotte, FL 33980 | 2006-07-07 |
| Find all providers in zip 33980 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025989 | Daniel Brooks Love | Nurse Practitioner | 705 E Virginia Ave, Punta Gorda, FL 33950-4540 | 2020-08-29 |
| 1437768835 | Stephanie Poitras | Nurse Practitioner | 17500 White Water Ct, Punta Gorda, FL 33982-9578 | 2020-07-31 |
| 1992314157 | Kimberly Presnell | Nurse Practitioner | 850 Bal Harbor Blvd, Punta Gorda, FL 33950-6510 | 2020-07-23 |
| 1376171496 | Andreea Nagy | Nurse Practitioner | 7400 S Blue Sage, Punta Gorda, FL 33955-1110 | 2020-04-01 |
| 1295291979 | Kristin Wilson | Nurse Practitioner | 350 E Olympia Ave, Suite 111, Punta Gorda, FL 33950 | 2019-02-18 |
| 1073935409 | Heather Lynn Darmetko | Nurse Practitioner | 713 E. Marion Ave. 1211 Suite 1211, Punta Gorda, FL 33950 | 2014-01-21 |
| 1568706380 | Steven Michael Byrne | Nurse Practitioner | 2310 Tamiami Trail, Suite 2101, Punta Gorda, FL 33950 | 2012-11-16 |
| 1053660415 | Consuelo Ranninger | Nurse Practitioner | 315 E. Olympia Avenue, Suite 111-112-223, Punta Gorda, FL 33950 | 2012-08-31 |
| 1790089035 | Catherine C Paradiso | Nurse Practitioner | 26601 Airport Rd, Punta Gorda, FL 33982 | 2010-12-30 |
| 1093898504 | Patricia Kizilay | Nurse Practitioner | 1756 Boca Raton Ct, Punta Gorda, FL 33950-5137 | 2006-10-20 |
| Find all providers in PUNTA GORDA | ||||
| City | PUNTA GORDA |
| Zip Code | 33980 |
Please comment or provide details below to improve the information on JOSEPH JELKS 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.