Individual provider · Type 1 NPI

William S. Wallace, APNP

Nurse Practitioner · West Bend, WI

NPI number 1467429860 Active

Practice location

1100 Gateway Ct
West Bend, WI 53095-8539

Call (262) 335-8600 Map

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other practice locations

700 W Central Ave, Suite 105, El Dorado, KS 67042-2184 · (316) 322-9813

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner	363LF0000X	KS44943 (KS)
Nurse Practitioner Primary	363L00000X	2475 (WI)

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 1467429860

William S. Wallace, APNP's National Provider Identifier is 1467429860, issued on Mar 3, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in West Bend, WI. The record was last updated on Jun 13, 2025.