MRS. VICTORIA ANNE WALLACE ANP NPI 1295769859

NPI Information

NPI: 1295769859
Provider Name: MRS. VICTORIA ANNE WALLACE, ANP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
1931 EAGAN AVE
FAIRBANKS CORRECTIONAL CENTER
FAIRBANKS, AK
ZIP 99701
Phone: (907) 458-6700
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MRS. Victoria Anne Wallace, ANP is a family nurse practitioner in Fairbanks, AK. MRS. Victoria Anne Wallace, ANP NPI is 1295769859. 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:

1931 EAGAN AVE
FAIRBANKS CORRECTIONAL CENTER
FAIRBANKS, AK
ZIP 99701-703
Phone: (907) 458-6700

The enumeration date for this NPI number is 7/10/2006 and was last updated on 6/14/2012.

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	713	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P35979	MEDICARE UPIN
2	160338	MEDICARE PIN
3	153051	MEDICARE PIN
4	MB0647238	OTHER	ALASKA	DEA
5	NP0254	MEDICAID	ALASKA
6	K162330	MEDICARE PIN	ALASKA
7	NP02541	MEDICAID	ALASKA
8	0361450001	MEDICARE NSC	ALASKA

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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