Kathryn Mary Wallace is a Portage, Indiana based nurse practitioner. Active license number of Kathryn Mary Wallace is 71000473A in Indiana. Her current practice location is 2640 Hamstrom Rd, Portage. Patients can reach her at 219-762-4423 or can fax her at 219-763-3120. Kathryn Mary Wallace is APRN, BC and her NPI number (Unique professional ID assigned by NPPES) is 1407965320. Kathryn Mary Wallace has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Kathryn Mary Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1407965320
NPI Enumeration Date:
30 Aug, 2006
NPI Last Update On:
17 Sep, 2012
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kathryn Mary Wallace are as mentioned below.
License Number
Specialization
State
Status
71000473A
Indiana
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Kathryn Mary Wallace such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
200056120A
Medicaid
Indiana
500004228
Other
Indiana
RAILROAD MEDICARE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Kathryn Mary Wallace 2640 Hamstrom Rd, Portage, Indiana
Zip:
46368-3832
Phone Number:
219-762-4423
Fax Number:
219-763-3120
Patients can reach Kathryn Mary Wallace at 2640 Hamstrom Rd, Portage, Indiana or can call to book an appointment on 219-762-4423.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 October, 2024.