Mr. Michael Alan Wallace
Nurse Practitioner - Family Medicine
8210 Louisiana Blvd Ne Suite C
Albuquerque
, New Mexico 87113-1761
Mr. Michael Alan Wallace
Nurse Practitioner - Family Medicine
8210 Louisiana Blvd Ne Suite C
Albuquerque
, New Mexico 87113-1761
(505) 858-1224
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About
Features
Specialties
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Mr. Michael Alan Wallace
- 8210 Louisiana Blvd Ne Suite C
- Albuquerque, NM
- Zip : 87113-1761
- Fax : (505) 858-1224
- Phone : (505) 858-1222
Second Address
- Mr. Michael Alan Wallace
- 8210 Louisiana Blvd Ne Suite C
- Albuquerque, NM
- Zip : 87113-1761
- Fax : (505) 858-1224
- Phone : (505) 858-1222
Reviews
FAQs
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Is Mr. Michael Alan Wallace a sole practitioner?
Is Mr. Michael Alan Wallace accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | R48828 | NM |
National Provider Identifier
| NPI | 1003057852 |
|---|---|
| Provider Name | Mr. Michael Alan Wallace |
| First Address | Albuquerque, NM 87113-1761 |
| Second Address | Albuquerque, NM 87113-1761 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/03/2009 |
| Last Update Date | 11/03/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 29623341 | (05) | NM |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.