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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. LA' TAYSIA WALLACE, MSN, RN, CPNP-PC

Active

MS. LA' TAYSIA WALLACE, MSN, RN, CPNP-PC is a Pediatric Nurse Practitioner healthcare provider located in HUNTINGTON STATION, New York. NPI 1114297074 is currently active in the NPPES registry. Verify at CMS.

Pediatric Nurse Practitioner · HUNTINGTON STATION, NY

Registration Details

NPI Number
1114297074
Provider Type
Individual
Gender
Female
NPI Issued
Jan 10, 2012 (14.555874712913 yrs)
Last Updated
Apr 2, 2024
Licenses
716807-1 (NY)
308886-1 (NY)
F383676-01 (NY)

Practice Information

Address
21 PENNY DR
HUNTINGTON STATION, NY, 117463422
Browse NY providers · Browse ZIP 11746
Phone
5168509623
Primary Specialty
Pediatric Nurse Practitioner
363LP0200X
Additional Specialty
Licensed Practical Nurse
Additional Specialty
Pediatric Nurse Practitioner

Other Pediatric Nurse Practitioner Providers in HUNTINGTON STATION, NY

Name Credential NPI
LOUISE KESSLER NP 1407957905
VITA ANNITTO N.P. 1598866147
MS. CAROL WATRAL CPNP 1730363821
MRS. GINA ANNE CARTWRIGHT NP 1063689859
MRS. ANTOINETTE CATHY CIAMPA PNP 1245470574
MARIA ELIZABETH NASIS-MATUZA MS, RN, CPNP 1871809707
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.