RYAN WALLACE NP NPI 1689389868

NPI Information

  • NPI: 1689389868
  • Provider Name: RYAN WALLACE, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 45 READE PL
    POUGHKEEPSIE, NY
    ZIP 12601
  • Phone: (917) 504-6635

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NPI Details

Ryan Wallace, NP is an adult health nurse practitioner in Poughkeepsie, NY with 5 years of experience. Ryan Wallace, NP NPI is 1689389868. 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:

45 READE PL
POUGHKEEPSIE, NY
ZIP 12601-947
Phone: (917) 504-6635

The NPI 1689389868 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 1/23/2023 and was last updated on 6/16/2025.

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
1163W00000XRegistered Nurse170263CONNECTICUTNo
2163W00000XRegistered Nurse639923NEW YORKNo
3363L00000XNurse Practitioner10962CONNECTICUTNo
4363LA2200XNurse PractitionerAdult Health310895NEW YORKYes

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: 11/21/2025

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