Amber Leigh Wallace, LPN is a
Licensed Practical Nurse based in Hart, Michigan. Amber Leigh Wallace is licensed to practice in Michigan (license number 4703108739) and her current practice location is
113 Riverside Dr, Hart, Michigan. She can be reached at her office (for appointments etc.) via phone at
(231) 220-4620.
NPI number for Amber Leigh Wallace is 1043673643 and her current mailing address is 113 Riverside Dr, Hart, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1043673643.
Provider's Profile
| Full Name | Amber Leigh Wallace |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 113 Riverside Dr, Hart, Michigan |
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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: 1043673643
- Provider Enumeration Date: 03/31/2016
- Last Update Date: 03/31/2016
Medical Identifiers
Medical identifiers for Amber Leigh Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043673643 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 4703108739 (Michigan) | 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. Amber Leigh 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 |
|---|
Amber Leigh Wallace, LPN
113 Riverside Dr,
Hart, MI 49420-1077
Ph: (231) 220-4620 | Amber Leigh Wallace, LPN
113 Riverside Dr,
Hart, MI 49420-1077
Ph: (231) 220-4620 |
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