Heather Wallace, is a
Licensed Practical Nurse based in Rodney, Michigan. Heather Wallace is licensed to practice in Michigan (license number 4703103229) and her current practice location is
16615 130th Ave, Rodney, Michigan. She can be reached at her office (for appointments etc.) via phone at
(517) 213-1341.
NPI number for Heather Wallace is 1568934362 and her current mailing address is 16615 130th Ave, Rodney, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1568934362.
Provider's Profile
Full Name | Heather Wallace |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 16615 130th Ave, Rodney, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1568934362
- Provider Enumeration Date: 12/19/2018
- Last Update Date: 12/19/2018
Medical Identifiers
Medical identifiers for Heather Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1568934362 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 4703103229 (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. Heather 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 |
Heather Wallace, 16615 130th Ave, Rodney, MI 49342-9707 Ph: () - | Heather Wallace, 16615 130th Ave, Rodney, MI 49342-9707 Ph: (517) 213-1341 |
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