Nichole Wallace

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

License

882146 Issued in NY

Practice address

450 Highland Ave
Mount Vernon, NY 10553-2109

Phone

(347) 213-6552

NPI assigned

Aug 10, 2026

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

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1265357305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 HIGHLAND AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532109",
            "telephone_number": "347-213-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 HIGHLAND AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532109",
            "telephone_number": "347-213-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NY",
            "license": "882146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Rosemarie Walker
• Lisa Walker, RN
• Novlette F Walker
• Shanique A. Walker
• Tamar Walker, MSED
• Symone Wallace
• Tabitha Wallace, RN
• Kimberly Wallach, STUDENT/INTERN
• Tanika Marie Walrond
• Courtenay Walsh

• Wound Care Registered Nurse in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Wound Care Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.