Allen Wallace in Roosevelt - Nurse Anesthetist, Certified Registered
Allen Wallace - NPI 1295798163
Allen Wallace is a Nurse Anesthetist, Certified Registered in Roosevelt, Utah. Allen Wallace practices all healthcare services and medical treatments related to Nurse Anesthetist, Certified Registered. The NPI Number for Allen Wallace is 1295798163. The last update date is 2007-11-30.
Allen Wallace's current location address is 250 W 300 N, Roosevelt, Utah. You can contact this provider via phone number 4357226163 and fax number 4357229291. The mailing address for Allen Wallace is 250 W 300 N, Roosevelt, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Allen Wallace |
|---|---|
| Address | 250 W 300 N, Roosevelt, Utah |
| Phone Number | 4357226163 |
| Fax Number | 4357229291 |
| Sole Proprietor | N |
| Credentials | CRNA |
NPI Number Detail
| NPI Number | 1295798163 |
|---|---|
| Provider Enumeration Date | 2006-04-10 |
| Last Updated Date | 2007-11-30 |
Provider Mailing Address Detail
| Address | 250 W 300 N |
|---|---|
| City | Roosevelt |
| State | Utah (UT) |
| Post Code | 840662336 |
| Phone Number | 4357226163 |
| Fax Number | 4357229291 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Anesthetist, Certified Registered |
|---|---|
| Taxonomy | 367500000X |
| Licence No | 192839-4406 |
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Definition: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D0808 | UT | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Allen Wallace?
The Allen Wallace has been issued the NPI (National Provider Identifier) 1295798163 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Allen Wallace's physical address?
The Allen Wallace is physically located at 250 W 300 N, in the city of Roosevelt, UT, with the postal code 840662336.
What is Allen Wallace's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Allen Wallace's specialized field of practice is Nurse Anesthetist, Certified Registered, and the corresponding taxonomy code that categorizes this area of specialization is 367500000X.
On what date did the Allen Wallace receive the assignment of its 1295798163 from the Centers for Medicare & Medicaid Services?
The Allen Wallace was issued its 1295798163 by the Centers for Medicare & Medicaid Services on 2006-04-10.
As of what date was the information regarding Allen Wallace, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Allen Wallace, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-11-30.