Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THERESA A WALLACE, PA-C, ATC
ActiveTHERESA A WALLACE, PA-C, ATC is a Physician Assistant healthcare provider located in DAYTONA BEACH, Florida. NPI 1437404548 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · DAYTONA BEACH, FL
Registration Details
- NPI Number
- 1437404548
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 16, 2012 (14.073041781604 yrs)
- Last Updated
- Nov 21, 2024
- Licenses
-
AL2836 (FL)PA9113017 (FL)
Practice Information
- Address
-
1865 LPGA BLVDDAYTONA BEACH, FL, 321177108Browse FL providers · Browse ZIP 32117
- Phone
- 3862554596
- Fax
- 3862583561
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in DAYTONA BEACH, FL
| Name | Credential | NPI |
|---|---|---|
| MRS. HEATHER L CRAWFORD | PA-C | 1871588830 |
| LAURA ANNE STONAKER | PA.C | 1225026503 |
| JENNIFER L FICK | PA-C | 1932182177 |
| MRS. ELIZABETH HUNT BAKER | PA C | 1801864681 |
| MRS. KANDACE F VAGOVIC | PA-C | 1336193044 |
| ANTHONY A. AZZARELLO | PA | 1073568747 |
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.