Provider / Organization | NPI | Date Certified |
---|---|---|
SAMANTHA WALLACE | 1881293272 | 2020-10-18 |
Samantha Wallace is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1881293272. Registration indicates Samantha Wallace is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
Entity Type | Individual |
Provider Name | Samantha Wallace APRN, FNP-C |
Practice Office Address | 7625 VOICE OF AMERICA CENTRE DR # 41 WEST CHESTER, OH US |
Practice Office Telephone | 5136444394 |
Mailing Address | 7625 VOICE OF AMERICA CENTRE DR # 41 WEST CHESTER, OH 450692795 US |
Code | Practice | License No State |
---|---|---|
363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | APRN.CNP.002739
OH |