Melody Elizabeth Wallace, RN, BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

163431 Issued in TX

Practice address

2625 Anita Dr
Garland, TX 75041

Phone

(972) 926-2671

Fax

(972) 926-2679

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Melody Elizabeth Joza Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Parents in Partnership Eci Program

  • Case Management Agency
  • Garland, TX
  • NPI 1912121724
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1265529937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 ANITA",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-926-2671",
            "fax_number": "972-926-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 ANITA DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75041",
            "telephone_number": "972-926-2671",
            "fax_number": "972-926-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MELODY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "0058400601",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "163431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "JOZA",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "RN, BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Stacy-Ann A. Walker-Hoyte
• Jimica Walls, RN
• Elijah Chang Wang, M.S., D.D.S
• Melissa Warden
• Nikkia Washington, CNWC
• Sumer Wassef, LBSW, LPC

• Registered Nurse in Garland, TX
• Providers in Garland, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.