Mrs Phyllis A Wallace, APRN in Konawa, OK

Mrs Phyllis A Wallace, APRN is a medicare enrolled "Nurse Practitioner - Family" in Konawa, Oklahoma. Her current practice location is 527 W 3rd St, Konawa, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (580) 925-3286.

Mrs Phyllis A Wallace is licensed to practice in Oklahoma (license number 35497) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1366486417.

Contact Information

	Mrs Phyllis A Wallace, APRN
	527 W 3rd St, Konawa, OK 74849-1415
	(580) 925-3286
	(580) 925-9149

Map and Direction

Provider's Profile

Full Name	Mrs Phyllis A Wallace
Gender	Female
Speciality
Experience	Years
Location	527 W 3rd St, Konawa, Oklahoma
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Phyllis A Wallace attended and graduated from in

NPI Data:

NPI Number: 1366486417
Provider Enumeration Date: 06/16/2006
Last Update Date: 11/22/2021

Medicare PECOS Information:

PECOS PAC ID:
Enrollment ID:

Medical Identifiers

Medical identifiers for Mrs Phyllis A Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366486417	NPI	-	NPPES
100155800A	Medicaid	OK
100155800B	Other	OK	SOONERCARE PROVIDER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LW0102X	Nurse Practitioner - Women's Health	R0035497 (Oklahoma)	Secondary
363LF0000X	Nurse Practitioner - Family	35497 (Oklahoma)	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 Phyllis A Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Phyllis A Wallace, APRN 527 W 3rd St, Konawa, OK 74849-1415 Ph: (580) 925-3286	Mrs Phyllis A Wallace, APRN 527 W 3rd St, Konawa, OK 74849-1415 Ph: (580) 925-3286

Reviews and Comments

Nurse Practitioner Nurses in Konawa, OK

Michel Danette Cosby, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 Fax: 580-925-2362
Emily Nicole Davis, APRN-CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286
Judy Pearce, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 527 W 3rd St, Konawa, OK 74849 Phone: 580-925-3286 Fax: 580-925-9149

Mrs Phyllis A Wallace, APRN - Medicare in Konawa, OK