Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KACIE WALLACE, M.S., PA-C
ActiveKACIE WALLACE, M.S., PA-C is a Physician Assistant healthcare provider located in DETROIT, Michigan. NPI 1750871455 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · DETROIT, MI
Registration Details
- NPI Number
- 1750871455
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 17, 2018 (8.2308765210523 yrs)
- Last Updated
- Sep 15, 2019
- License
-
1151843 (MI)
Practice Information
- Address
-
22101 MOROSS RDDETROIT, MI, 482362148Browse MI providers · Browse ZIP 48236
- Phone
- 3133434000
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in DETROIT, MI
| Name | Credential | NPI |
|---|---|---|
| JENNY L GRUNWALD | P.A.-C | 1124013016 |
| KAREN L BRONSON | PA-C | 1295722270 |
| MRS. SUSAN LYNN SIEPIERSKI | PA | 1609857952 |
| AMY DERECZYK | PA-C | 1558349050 |
| JULIA SWITZER | PA | 1528046505 |
| CAROLE VANDYKE | P.A. | 1114997228 |
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.