Individual provider · Type 1 NPI

Kathleen Wallace, APN

Nurse Practitioner · Merrillville, IN

NPI number 1225035504 Active

Practice location

90 W 86th Ave
Merrillville, IN 46410-7086

Fax (219) 791-1560

Mailing address

120 W 22nd St Ste 200
Oak Brook, IL 60523-1563

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X71000826A (IN)

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 1225035504

Kathleen Wallace, APN's National Provider Identifier is 1225035504, issued on Jul 1, 2005. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Merrillville, IN. The record was last updated on Dec 13, 2022.