Louwanna M Wallace (NPI# 1649304882, PAC ID# 3678710480) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1649304882 |
| PAC ID by PECOS | 3678710480 |
| Professional Enrollment ID | I20140414000434 |
| Full Name | Louwanna M Wallace |
| Organization Legal Name | VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC |
| Address |
201 W Academy St Vermillion Parke Community Health Center Inc Bloomingdale IN 47832-8095 |
| Phone Number | 7654989000 |
| Gender | F |
| Graduation Year | 1995 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7618067265 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 151326 | UNION HOSPITAL CLINTON |
| Address | Phone | Organization |
|---|---|---|
| 201 W Academy St, Vermillion Parke Community Health Center Inc, Bloomingdale, IN 47832-8095 | 7654989000 | VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC |
| 777 S Main St, Suite 100, Clinton, IN 47842-2493 | 7658281003 | VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC |
| Organization Legal Name | VALLEY PROFESSIONALS COMMUNITY HEALTH CENTER INC |
| Physicians | 36 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sean P Ewing | Family Medicine | Valley Professionals Community Health Center Inc | 703 W Park St, Cayuga, IN 47928-8207 |
| Jordan Ryley | Nurse Practitioner | Valley Professionals Community Health Center Inc | 727 N Lincoln Rd, Rockville, IN 47872-1117 |
| Patrick L Foley | Family Medicine | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Lisa Karen Tincher | Nurse Practitioner | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Christopher M Fitzsimmons | Family Medicine | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Gretchen Blevins | Nurse Practitioner | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Randall Lee Stevens | Family Medicine | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Brandie D Ruark | Nurse Practitioner | Valley Professionals Community Health Center Inc | 727 N Lincoln Rd, Rockville, IN 47872-1117 |
| Bing Wang Gale | Family Medicine | Valley Professionals Community Health Center Inc | 777 S Main St, Suite 100, Clinton, IN 47842-2493 |
| Puja M Sharma | Family Medicine | Valley Professionals Community Health Center Inc | 1530 N 7th St, Suite 201, Terre Haute, IN 47807-1061 |
| Street Address |
201 W ACADEMY ST VERMILLION PARKE COMMUNITY HEALTH CENTER INC |
| City | BLOOMINGDALE |
| State | IN |
| Zip | 47832-8095 |
| City | BLOOMINGDALE |
| Zip Code | 47832 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BLOOMINGDALE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Louwanna M 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.