Individual provider · Type 1 NPI
Stephanie Ruth Wallace, APRN-NP
Psychiatric/Mental Health Nurse Practitioner · Athens, GA
NPI number
1124087879
Active
Practice location
745 S Milledge Ave Ste 1A
Athens, GA 30605-1292
Fax (706) 498-9568
Mailing address
4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7725
Other practice locations
- 1230 Baxter St, Athens, GA 30606-3712 · (706) 389-2273
- 1199 Prince Ave, Athens, GA 30606-2797 · (706) 475-5076
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN136273 (GA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN-NP136273 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
14 other providers at this address
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- Enyang Etengeneng, PMHNPPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1306391198
- Heather Joyce White-McClane, LPCProfessional Counselor Athens, GA NPI 1932689122
- Jana Suzanne Mastrogiovanni, LPCProfessional Counselor Athens, GA NPI 1730469826
- Jessica Lane Clark, PMHNPPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1093387664
- Joel Herman Gibson Jr., LPCProfessional Counselor Athens, GA NPI 1619345741
- Kelley Dyanne Sproles, LMFTMarriage & Family Therapist Athens, GA NPI 1972090538
- Kimberly Lynn Roth, M.A.Professional Counselor Athens, GA NPI 1942323100
- Nancy Renee Westmoreland, LCSWClinical Social Worker Athens, GA NPI 1588353379
- Shakera Hawkins, LMFTMarriage & Family Therapist Athens, GA NPI 1215798475
- Shaleacia Shipman, APRN-NPPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1154888147
Other psychiatric/mental health nurse practitioner providers in Athens
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- Kimberly AbuajahPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1083203426
- Obianuju Okpala, NPPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1093335853
- Frank Tichorla WajulePsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1093361719
- Jessica Lane Clark, PMHNPPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1093387664
- Karl SmartPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1124295332
- Henrietta June Rogers-Cathey, PMHNP-BC, FNP-BCPsychiatric/Mental Health Nurse Practitioner Athens, GA NPI 1144955840
About NPI 1124087879
Stephanie Ruth Wallace, APRN-NP's National Provider Identifier is 1124087879, issued on Mar 21, 2006. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Athens, GA. The record was last updated on Oct 13, 2026.