Dr Nicole Marie Wallis, MD | |
1200 Grant Blvd W, Wabasha, MN 55981-1042 | |
(651) 565-4531 | |
Not Available |
Full Name | Dr Nicole Marie Wallis |
---|---|
Gender | Female |
Speciality | Emergency Medicine |
Experience | 20 Years |
Location | 1200 Grant Blvd W, Wabasha, Minnesota |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346443728 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 70944 (Minnesota) | Primary |
207P00000X | Emergency Medicine | 35089618 (Ohio) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
St Elizabeth Medical Center | Wabasha, MN | Hospital |
Metrohealth System | Cleveland, OH | Hospital |
Cleveland Clinic | Cleveland, OH | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Cleveland Clinic Foundation | 1850203555 | 5680 |
The Metrohealth System | 8628982949 | 1029 |
Saint Elizabeths Hospital Of Wabasha Inc | 5092619387 | 78 |
Entity Name | The Cleveland Clinic Foundation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679525919 PECOS PAC ID: 1850203555 Enrollment ID: O20031103000049 |
Entity Name | The Metrohealth System |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053353896 PECOS PAC ID: 8628982949 Enrollment ID: O20031119000355 |
Entity Name | Cleveland Clinic Health Services Professional Association Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770082471 PECOS PAC ID: 3577813005 Enrollment ID: O20221201002216 |
Mailing Address | Practice Location Address |
---|---|
Dr Nicole Marie Wallis, MD 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Dr Nicole Marie Wallis, MD 1200 Grant Blvd W, Wabasha, MN 55981-1042 Ph: (651) 565-4531 |
Dr. Paul C Nystrom, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 Grant Blvd W, Wabasha, MN 55981 Phone: 651-565-4531 | |
Mark Sandefur, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 Grant Blvd W, Wabasha, MN 55981 Phone: 608-782-7300 |