Angela M Wallace, NP

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

0024093871 Issued in VA

Practice address

9300 Dewitt Loop Dept of
Ft Belvoir, VA 22060-5285

Phone

(571) 231-1015

NPI assigned

Jan 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Angela R Massey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1073584652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP DEPT OF",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP DEPT OF",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "VA",
            "license": "0024093871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "MASSEY",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Scott Wadding, D.O.
• Eric Martin Wagner, PA-C
• Waler Reed Army Medical Center (Dewitt Army Hospital center)
• Caitlin E Walker, OTR/L, CHT
• Precious Jewel Walker, COTA
• Tracey Lee Walsh-Chocolaad, PHARM.D., BCOP
• Shahid A Waraich, M.D.
• Candace Ward, MD, MPH
• Marion Ward, MD
• Jesse Warren, DO

• Critical Care Neonatal Nurse Practitioner in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Critical Care Neonatal Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.