ISSAIAH WALLACE PMHNP NPI 1508422338

NPI Information

NPI: 1508422338
Provider Name: ISSAIAH WALLACE, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
936 SHARPE HOSPITAL RD
WESTON, WV
ZIP 26452
Phone: (304) 269-1210
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Issaiah Wallace, PMHNP is a psychiatric/mental health nurse practitioner in Weston, WV with 6 years of experience. Issaiah Wallace, PMHNP NPI is 1508422338. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

936 SHARPE HOSPITAL RD
WESTON, WV
ZIP 26452-550
Phone: (304) 269-1210

The NPI 1508422338 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 5/16/2019 and was last updated on 5/16/2019.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	102650	WEST VIRGINIA	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: 4/28/2024

NPI Synchronization or Removal

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