Individual provider · Type 1 NPI
Laury M. Wallace, NP
Gerontology Nurse Practitioner · Westfield, IN
NPI number
1205343845
Active
Practice location
16731 Gaither Blvd
Westfield, IN 46074-4607
Fax (812) 239-3771
Other practice locations
- 3760 Mullan Rd, Missoula, MT 59808-5123 · (406) 551-2273
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 71007724A (IN) |
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | 71007724A (IN) |
| Adult Medicine Physician | 207QA0505X | 71007724A (IN) |
| Primary Care Nurse Practitioner | 363LP2300X | APRN-286647 (MT) |
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 71007724A (IN) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | APRN-286647 (MT) |
Gerontology Nurse Practitioner: Definition to come...
Other gerontology nurse practitioner providers in Westfield
About NPI 1205343845
Laury M. Wallace, NP's National Provider Identifier is 1205343845, issued on Jan 4, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Westfield, IN. The record was last updated on Oct 28, 2026.