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

RAFAELLA IZAR WALLACE, ANP

Active

RAFAELLA IZAR WALLACE, ANP is a Gerontological Nurse Practitioner healthcare provider located in FORT WORTH, Texas. NPI 1821469107 is currently active in the NPPES registry. Verify at CMS.

Gerontological Nurse Practitioner · FORT WORTH, TX

Registration Details

NPI Number
1821469107
Provider Type
Individual
Gender
Female
NPI Issued
Oct 13, 2015 (10.836036026678 yrs)
Last Updated
Dec 1, 2021
Licenses
AP129253 (TX)
AP129253 (TX)

Practice Information

Address
500 S HENDERSON ST STE 200
FORT WORTH, TX, 761042154
Browse TX providers · Browse ZIP 76104
Phone
8174131500
Fax
8174131499
Primary Specialty
Gerontological Nurse Practitioner
363LG0600X

Other Gerontological Nurse Practitioner Providers in FORT WORTH, TX

Name Credential NPI
BARBARA L HARTY GNP 1184688053
MS. VIRGINIA L MILOUD GNP 1174569735
MS. ODDETH ROOT MSN, RN-BC, NP 1215945522
PENNY MARIE BROOKOVER GNP 1316010507
KIMBERLY POSEY ANP-C 1326261223
JAYSON PORTER HOPPE NP 1366888919
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.