Individual provider · Type 1 NPI
Sonny S. Wallace, NP
Nurse Practitioner · Omaha, NE
Practice location
7500 Mercy Rd
Omaha, NE 68124-2319
Fax (402) 398-5589
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | H152173 (IA) |
| Nurse Practitioner Primary | 363L00000X | 112565 (NE) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1164909339
Sonny S. Wallace, NP's National Provider Identifier is 1164909339, issued on Jul 20, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Omaha, NE. The record was last updated on Sep 20, 2018.