Mrs Angie Marie Wallace, CRNP is a
Clinical Nurse Specialist - Pediatrics based in Waynesboro, Pennsylvania. Mrs Angie Marie Wallace is licensed to practice in Pennsylvania (license number SP009803) and her current practice location is
45 Roadside Ave Frnt, Waynesboro, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at
(717) 387-8060.
NPI number for Mrs Angie Marie Wallace is 1881856615 and her current mailing address is 22 St Paul Dr Ste 200, Chambersburg, Pennsylvania. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1881856615.
Provider's Profile
| Full Name | Mrs Angie Marie Wallace |
|---|
| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Pediatrics |
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| Location | 45 Roadside Ave Frnt, Waynesboro, Pennsylvania |
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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: 1881856615
- Provider Enumeration Date: 07/02/2008
- Last Update Date: 09/11/2017
Medical Identifiers
Medical identifiers for Mrs Angie Marie Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881856615 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 364SP0200X | Clinical Nurse Specialist - Pediatrics | SP009803 (Pennsylvania) | 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. Mrs Angie Marie 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 |
|---|
Mrs Angie Marie Wallace, CRNP
22 St Paul Dr Ste 200,
Chambersburg, PA 17201-1033
Ph: (717) 709-7922 | Mrs Angie Marie Wallace, CRNP
45 Roadside Ave Frnt,
Waynesboro, PA 17268-2543
Ph: (717) 387-8060 |
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