Maggie Mae Wallace, | |
200 Office Park Dr, Gulf Shores, AL 36542-3432 | |
(251) 968-7379 | |
(251) 968-5960 |
Full Name | Maggie Mae Wallace |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 5 Years |
Location | 200 Office Park Dr, Gulf Shores, Alabama |
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 |
---|---|---|---|
1366098642 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 8373 (Connecticut) | Secondary |
363LF0000X | Nurse Practitioner - Family | 1-182953 (Alabama) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
South Baldwin Regional Medical Center | Foley, AL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Foley Clinic Corp. | 5193741759 | 83 |
Entity Name | Foley Clinic Corp. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629027826 PECOS PAC ID: 5193741759 Enrollment ID: O20051021000930 |
Entity Name | Fairhope Family Medicine, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821151093 PECOS PAC ID: 1052311230 Enrollment ID: O20070111000599 |
Mailing Address | Practice Location Address |
---|---|
Maggie Mae Wallace, 200 Office Park Dr, Gulf Shores, AL 36542-3432 Ph: (512) 968-7379 | Maggie Mae Wallace, 200 Office Park Dr, Gulf Shores, AL 36542-3432 Ph: (251) 968-7379 |
Clarissa Jordan Annan, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 156 E 15th Ave, Gulf Shores, AL 36542 Phone: 251-948-4290 Fax: 251-948-7682 | |
Erin Dewrell Prendergast, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1700 W 2nd St, Gulf Shores, AL 36542 Phone: 251-967-4000 Fax: 251-967-2398 | |
Mr. Jerry Wayne Barton Jr., NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 E 15th Ave, Gulf Shores, AL 36542 Phone: 251-962-1250 Fax: 251-967-7832 | |
Lisa Ellen Field, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Office Park Dr, Gulf Shores, AL 36542 Phone: 251-968-7379 Fax: 251-968-5960 | |
Anthony Houston Key, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 E 15th Ave, Gulf Shores, AL 36542 Phone: 251-962-1250 Fax: 251-967-7832 | |
Rebecca Lee Branum Autrey, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 232 Office Park Dr, Gulf Shores, AL 36542 Phone: 251-968-2323 Fax: 251-968-2134 |