Gloria Elizabeeth Wallace Jr., RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

468506 Issued in NY

Practice address

141 Macon St
Brooklyn, NY 11216-2206

Phone

(718) 230-9734

Fax

(718) 230-9734

NPI assigned

Mar 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1154697191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MACON ST",
            "address_2": "RM 127",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162206",
            "telephone_number": "718-230-9734",
            "fax_number": "718-230-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MACON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162206",
            "telephone_number": "718-230-9734",
            "fax_number": "718-230-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "GLORIA",
        "middle_name": "ELIZABEETH",
        "name_prefix": "Ms.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "468506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace Health, Inc.
• Georgia Wallace-Scott
• Dorian James Wallace, MT-BC
• Elese Marlene Wallace, LPN
• Giselle Fourier Wallace, DDS
• James Richard Wallace, M.D.
• Margaret Wallace
• Marisa Wallace, M.S. CCC-SLP
• Nichole Wallace, PA
• Pamela Wallace, LCSW

• School Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• School Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.