Individual provider · Type 1 NPI

Issaiah Wallace, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Weston, WV

NPI number 1508422338 Active

Practice location

936 Sharpe Hospital Rd
Weston, WV 26452-8550

Mailing address

PO Box 12
Enterprise, WV 26568-0012

Other practice locations

  • 132 William Ln, Mount Clare, WV 26408-7227 · (304) 712-4358

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X102650 (WV)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1508422338

Issaiah Wallace, PMHNP's National Provider Identifier is 1508422338, issued on May 16, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Weston, WV. The record was last updated on Sep 22, 2025.