Individual provider · Type 1 NPI
Kathryn Mary Wallace, APRN, BC
Nurse Practitioner · Portage, IN
Practice location
2640 Hamstrom Rd
Portage, IN 46368-3832
Fax (219) 763-3120
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 71000473A (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 1407965320
Kathryn Mary Wallace, APRN, BC's National Provider Identifier is 1407965320, issued on Aug 30, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Portage, IN. The record was last updated on Sep 17, 2012.