Individual provider · Type 1 NPI
Miata Wallace, PA
Physician Assistant · Lincoln, NE
Practice location
1500 S 58th St Ste 800
Lincoln, NE 68506-1407
Fax (402) 483-8689
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant Primary | 363A00000X | 2760 (NE) |
Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…
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About NPI 1013656990
Miata Wallace, PA's National Provider Identifier is 1013656990, issued on May 31, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Lincoln, NE. The record was last updated on Mar 25, 2025.