Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KATHRYN MARY WALLACE, APRN, BC
ActiveKATHRYN MARY WALLACE, APRN, BC is a Nurse Practitioner healthcare provider located in PORTAGE, Indiana. NPI 1407965320 is currently active in the NPPES registry. Verify at CMS.
Nurse Practitioner · PORTAGE, IN
Registration Details
- NPI Number
- 1407965320
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 30, 2006 (19.914877166731 yrs)
- Last Updated
- Sep 17, 2012
- License
-
71000473A (IN)
Practice Information
- Address
-
2640 HAMSTROM RDPORTAGE, IN, 463683832Browse IN providers · Browse ZIP 46368
- Phone
- 2197624423
- Fax
- 2197633120
- Primary Specialty
-
Nurse Practitioner
363L00000X
Other Nurse Practitioner Providers in PORTAGE, IN
| Name | Credential | NPI |
|---|---|---|
| MS. AMY LORRAINE SOBAS | N.P. | 1205872132 |
| MRS. KRISTA S NGUYEN | NP-C | 1669936498 |
| KELLI HOLLAND | NP | 1962108837 |
| KELLY POLLARD | AGACNP | 1033904396 |
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.