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

KATIE JUSTINE WALLACE, FNP-BC

Active

KATIE JUSTINE WALLACE, FNP-BC is a Family Nurse Practitioner healthcare provider located in MASHPEE, Massachusetts. NPI 1790151967 is currently active in the NPPES registry. Verify at CMS.

Family Nurse Practitioner · MASHPEE, MA

Registration Details

NPI Number
1790151967
Provider Type
Individual
Gender
Female
NPI Issued
Aug 11, 2015 (10.969178439419 yrs)
Last Updated
Jan 4, 2016
Licenses
RN2264353 (MA)
RN2264353 (MA)

Practice Information

Address
MASHPEE FAMILY MEDICINE 5 INDUSTRIAL DRIVE
SUITE 100
MASHPEE, MA, 02649
Browse MA providers · Browse ZIP 02649
Phone
5084774282
Fax
5085396134
Primary Specialty
Family Nurse Practitioner
363LF0000X
Additional Specialty
Family Nurse Practitioner

Other Family Nurse Practitioner Providers in MASHPEE, MA

Name Credential NPI
MRS. SHARON CICCHETTI ROUSSEAU FNP 1538105903
MR. KYLE C CHAPLIC NP-C 1730444936
MRS. KELSEY ANNE SIMM DNP 1376936815
LEANN LYNN SWANSON FNP-BC 1740651215
KAREN GAUVIN RN 1619492923
EMILY ELGERT FNP-BC 1336791680
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.