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MAGGIE MAE WALLACE NPI 1366098642


NPI Information

NPI: 1366098642
Provider Name: MAGGIE MAE WALLACE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
200 OFFICE PARK DR
GULF SHORES, AL
ZIP 36542
Phone: (251) 968-7379
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Maggie Mae Wallace is a family nurse practitioner in Gulf Shores, AL with 5 years of experience. Maggie Mae Wallace NPI is 1366098642. 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:

200 OFFICE PARK DR
GULF SHORES, AL
ZIP 36542-432
Phone: (251) 968-7379
Fax: (251) 968-5960

The NPI 1366098642 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 8/13/2019 and was last updated on 11/13/2023.


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
1363LF0000XNurse PractitionerFamily8373CONNECTICUTNo
2363LF0000XNurse PractitionerFamily1-182953ALABAMAYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.