Adrienne Wallace, is a
Registered Nurse based in Weldon Springs, Missouri. Adrienne Wallace is licensed to practice in Missouri (license number 2010010977) and her current practice location is
300 Breeze Park Dr., Weldon Springs, Missouri. She can be reached at her office (for appointments etc.) via phone at
(636) 720-3090.
NPI number for Adrienne Wallace is 1245903863 and her current mailing address is 5072 Douglas Park Dr, Saint Peters, Missouri. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245903863.
Provider's Profile
| Full Name | Adrienne Wallace |
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| Gender | Female |
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| Speciality | Registered Nurse |
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| Location | 300 Breeze Park Dr., Weldon Springs, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245903863
- Provider Enumeration Date: 07/29/2021
- Last Update Date: 07/29/2021
Medical Identifiers
Medical identifiers for Adrienne Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245903863 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 2010010977 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Adrienne Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Adrienne Wallace,
5072 Douglas Park Dr,
Saint Peters, MO 63304
Ph: (636) 720-3090 | Adrienne Wallace,
300 Breeze Park Dr.,
Weldon Springs, MO 63304
Ph: (636) 720-3090 |
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