Mary Michelle Wallace, NP - Nurse Practitioner in Phoenix, AZ

Mary Michelle Wallace, NP is a Nurse Practitioner - Psychiatric/mental Health based in Phoenix, Arizona. Mary Michelle Wallace is licensed to practice in Arizona (license number RN030118) and her current practice location is 444 N 44th St, #200, Phoenix, Arizona. She can be reached at her office (for appointments etc.) via phone at (602) 685-3846.

NPI number for Mary Michelle Wallace is 1417176546 and her current mailing address is 444 N 44th St, #200, Phoenix, Arizona. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417176546.

Contact Information

Mary Michelle Wallace, NP
444 N 44th St, #200,
Phoenix, AZ 85008-7624
(602) 685-3846
(602) 685-3808

Map and Direction




Provider's Profile

Full NameMary Michelle Wallace
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location444 N 44th St, Phoenix, Arizona
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1417176546
  • Provider Enumeration Date: 04/25/2007
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Mary Michelle Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417176546NPI-NPPES
637184MedicaidAZ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health RN030118 (Arizona)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. Mary Michelle 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 AddressPractice Location Address
Mary Michelle Wallace, NP
444 N 44th St, #200,
Phoenix, AZ 85008-7624

Ph: (602) 685-3846
Mary Michelle Wallace, NP
444 N 44th St, #200,
Phoenix, AZ 85008-7624

Ph: (602) 685-3846

Reviews and Comments


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