Alexandria Wallace (NPI# 1811468135, PAC ID# 2466791363) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1811468135 |
| PAC ID by PECOS | 2466791363 |
| Professional Enrollment ID | I20190311001065 |
| Full Name | Alexandria Wallace |
| Organization Legal Name | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Address |
8121 Madison Blvd Suite 101a Madison AL 35758-2082 |
| Phone Number | 2563256499 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3476735648 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 | CRESTWOOD PHYSICIAN SERVICES, LLC | |
| 8121 Madison Blvd, Suite 101a, Madison, AL 35758-2082 | 2563256499 | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Organization Legal Name | CRESTWOOD PHYSICIAN SERVICES, LLC |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberley Brooke Tanner | Nurse Practitioner | Crestwood Physician Services, LLC | 2506 Danville Rd Sw, Suite 204b, Decatur, AL 35603-4234 |
| Mylena Morton | Internal Medicine | Crestwood Physician Services, LLC | 8121 Madison Blvd, Suite 101a, Madison, AL 35758-2082 |
| Carisa F Sparks | Nurse Practitioner | Crestwood Physician Services, LLC | 11365 Hwy 231 431 N, Meridianville, AL 35759-2145 |
| David R Mayer | Family Medicine | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Charles D. Coffey | Family Medicine | Crestwood Physician Services, LLC | 12100 County Line Rd, Suite A2, Madison, AL 35756-2006 |
| Bhavna Sharma | Family Medicine | Crestwood Physician Services, LLC | 102 Essex Ct, Suite C, Madison, AL 35758-3161 |
| Jenny C Chapman | Family Medicine | Crestwood Physician Services, LLC | 10300 Bailey Cove Rd Se, Suite 13, Huntsville, AL 35803-2635 |
| Amber J Whitfield | Family Medicine | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Valerie L Wright | Family Medicine | Crestwood Physician Services, LLC | 1650 Slaughter Rd, Suite A, Madison, AL 35758-8610 |
| Mary E Barry | Nurse Practitioner | Crestwood Physician Services, LLC | 4810 Whitesport Cir Sw, Huntsville, AL 35801-7420 |
| Street Address |
8121 MADISON BLVD SUITE 101A |
| City | MADISON |
| State | AL |
| Zip | 35758-2082 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mylena Morton | Internal Medicine | Crestwood Physician Services, LLC | 8121 Madison Blvd, Suite 101a, Madison, AL 35758-2082 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy L Beck | Nurse Practitioner | American Family Care Inc | 7559 Hwy 72 W, Madison, AL 35758 |
| Deborah Kolb | Family Medicine | 8371 Hwy 72 W, Suite 200, Madison, AL 35758 | |
| Regina M Doody-lundy | Psychiatry | 708 Will Halseyway C, Madison, AL 35758 | |
| Kelly Vazquez | Nurse Practitioner | Huntsville Hospital Lung Center | 8371 Hwy 72 W, Suite 204, Madison, AL 35758 |
| Robert Andrew Serio | Pulmonary Disease | Huntsville Hospital Lung Center | 8371 Hwy 72 W, Suite 204, Madison, AL 35758 |
| Jeremy Tyler Johnson | Family Medicine | American Family Care Inc | 7559 Hwy 72 W, Madison, AL 35758 |
| Alicia Vasquez | Nurse Practitioner | Huntsville Hospital Lung Center | 8371 Hwy 72 W, Suite 204, Madison, AL 35758 |
| Brent H Ledford | Certified Registered Nurse Anesthetist (crna) | Huntsville Hospital Anesthesia | 8375 Hwy 72 W, Madison, AL 35758 |
| Charles K Mackenzie | Certified Registered Nurse Anesthetist (crna) | Huntsville Hospital Anesthesia | 8375 Hwy 72 W, Madison, AL 35758 |
| Sandra J Carmichael | General Practice | American Family Care Inc | 7559 Hwy 72 W, Madison, AL 35758 |
| Find all physicians in zip 35758 | |||
| City | MADISON |
| Zip Code | 35758 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MADISON + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Alexandria Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.