Donna M Wallace is a Family in Bridgeport, Connecticut. Donna M Wallace practices all healthcare services and medical treatments related to Family. The NPI Number for Donna M Wallace is 1154577047. The last update date is 2014-08-22.
Donna M Wallace's current location address is 46 Albion St, Bridgeport, Connecticut. You can contact this provider via phone number 2033323155 and fax number 2033306008. The mailing address for Donna M Wallace is 46 Albion St, Bridgeport, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Donna M Wallace |
|---|---|
| Address | 46 Albion St, Bridgeport, Connecticut |
| Phone Number | 2033323155 |
| Fax Number | 2033306008 |
| Sole Proprietor | N |
| Credentials | ARPN |
NPI Number Detail
| NPI Number | 1154577047 |
|---|---|
| Provider Enumeration Date | 2008-08-12 |
| Last Updated Date | 2014-08-22 |
Provider Mailing Address Detail
| Address | 46 Albion St |
|---|---|
| City | Bridgeport |
| State | Connecticut (CT) |
| Post Code | 66052602 |
| Phone Number | 2033323155 |
| Fax Number | 2033306008 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 3840 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3840 | CT | STATE LICENSE 003840 | |
| 4236130 | CT | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Donna M Wallace by the Centers for Medicare & Medicaid Services (CMS)?
The Donna M Wallace has been assigned the NPI (National Provider Identifier) 1154577047. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Donna M Wallace's physical address?
The Donna M Wallace is physically located at 46 Albion St, in the city of Bridgeport, CT, with the postal code 66052602.
What is the Donna M Wallace's specialty and taxonomy code?
The Donna M Wallace's specialty is Family, and the corresponding taxonomy code is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1154577047 to Donna M Wallace?
The Donna M Wallace received its 1154577047 assignment from the Centers for Medicare & Medicaid Services on 2008-08-12.
As of what date were the details pertaining to Donna M Wallace last refreshed?
The information related to the Donna M Wallace, including its address, specialty, and other relevant details, was last updated on 2014-08-22.
NPI Number: 1669475885
Address: 1005 Midwestern Pkwy, Wichita Falls, TX
NPI Number: 1285637785
Address: 101 Deer Run Rd, Elgin, SC