JUSTIN COVEY WALLACE RN NPI 1578807103

NPI Information

NPI: 1578807103
Provider Name: JUSTIN COVEY WALLACE, RN
Classification: Registered Nurse - 163WE0003X
Entity Type: Individual

Specialization: Emergency

Address:
4212 N 16TH ST
PHOENIX, AZ
ZIP 85016
Phone: (602) 263-1200
Get Directions

Justin Covey Wallace, RN is an emergency registered nurse in Phoenix, AZ. Justin Covey Wallace, RN NPI is 1578807103. 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:

4212 N 16TH ST
PHOENIX, AZ
ZIP 85016-319
Phone: (602) 263-1200

The enumeration date for this NPI number is 11/20/2012 and was last updated on 11/20/2012.

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	163WE0003X	Registered Nurse	Emergency	RN173423	ARIZONA	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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