NPI Registry.org

Elizabeth Ann Wallace

NPI Registration Record

Provider / OrganizationNPIDate Certified
ELIZABETH ANN WALLACE19821593562024-09-06

Elizabeth Wallace [F] graduated in 2016 and primarily specializes in Nurse Practitioner.

Elizabeth Ann Wallace is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1982159356. Registration indicates Elizabeth Ann 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, ) Access to Adult/Geriatric Primary Care Providers (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, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)

PECOS ID4486941077
RegistrationPART-B:Y
DME:Y
HHA:Y
PMD:Y
Entity TypeIndividual
Provider Name Elizabeth Ann Wallace FNP-BC
Other Provider Name Elizabeth A Blair
Practice Office Address2001 LAUREL AVE STE 105
KNOXVILLE, TN US
Practice Office Telephone8655779247
Practice Office Fax8339082095
Mailing Address1275 DICK LONAS RD
KNOXVILLE, TN 379091382 US
Business Telephone8655844747
Business Fax8653811509
HPT Codes
CodePractice
License No
State
363LF0000X PRIMARYAccess 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
21538
TN
363L00000XAccess 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

All Other Specialties & Provider Types

Nurse Practitioner
Physician Assistants & Advanced Practice Nursing Providers
21538
TN
OPI Codes
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