Mrs Sondra Ann Wallace, is a
Licensed Practical Nurse based in Quitman, Georgia. Mrs Sondra Ann Wallace is licensed to practice in Florida (license number PN5179834) and her current practice location is
96 Perdue Rd, Quitman, Georgia. She can be reached at her office (for appointments etc.) via phone at
(229) 272-4376.
NPI number for Mrs Sondra Ann Wallace is 1275074783 and her current mailing address is 96 Perdue Rd, Quitman, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1275074783.
Provider's Profile
| Full Name | Mrs Sondra Ann Wallace |
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| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 96 Perdue Rd, Quitman, Georgia |
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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: 1275074783
- Provider Enumeration Date: 03/16/2017
- Last Update Date: 03/16/2017
Medical Identifiers
Medical identifiers for Mrs Sondra Ann Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275074783 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | PN5179834 (Florida) | 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 Sondra Ann 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 Sondra Ann Wallace,
96 Perdue Rd,
Quitman, GA 31643-3648
Ph: (229) 272-4376 | Mrs Sondra Ann Wallace,
96 Perdue Rd,
Quitman, GA 31643-3648
Ph: (229) 272-4376 |
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