Mary Ruth Wallis, is a
Licensed Practical Nurse based in Eaton, New York. Mary Ruth Wallis is licensed to practice in New York (license number 332738) and her current practice location is
2516 Candy Ln Lot 17, Eaton, New York. She can be reached at her office (for appointments etc.) via phone at
(315) 679-1638.
NPI number for Mary Ruth Wallis is 1790430650 and her current mailing address is 2516 Candy Ln Lot 17, Eaton, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1790430650.
Provider's Profile
| Full Name | Mary Ruth Wallis |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
|---|
| Location | 2516 Candy Ln Lot 17, Eaton, New York |
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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: 1790430650
- Provider Enumeration Date: 02/18/2022
- Last Update Date: 02/18/2022
Medical Identifiers
Medical identifiers for Mary Ruth Wallis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790430650 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | 332738 (New York) | 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 Ruth Wallis 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 |
|---|
Mary Ruth Wallis,
2516 Candy Ln Lot 17,
Eaton, NY 13334-3286
Ph: (315) 679-1638 | Mary Ruth Wallis,
2516 Candy Ln Lot 17,
Eaton, NY 13334-3286
Ph: (315) 679-1638 |
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