MELISSA ANN WALLACE CRNP NPI 1023524501

NPI Information

NPI: 1023524501
Provider Name: MELISSA ANN WALLACE, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC

PECOS Registration: Yes

Address:
905 UNIVERSITY DR
STATE COLLEGE, PA
ZIP 16801
Phone: (814) 238-8418
Get Directions

Melissa Ann Wallace, CRNP is a family nurse practitioner in State College, PA with 7 years of experience. Melissa Ann Wallace, CRNP NPI is 1023524501. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

905 UNIVERSITY DR
STATE COLLEGE, PA
ZIP 16801-626
Phone: (814) 238-8418
Fax: (814) 234-2888

The NPI 1023524501 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/20/2017 and was last updated on 11/7/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	SP018172	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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