Huong Tran Wallace, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP09238 Issued in LA

Practice address

70411 Highway 21
Covington, LA 70433-8243

Phone

(985) 400-5566

Fax

(985) 400-5560

NPI assigned

Apr 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: hwallace3172655@direct.casso.us.com

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306371216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "985-400-5566",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70411 HIGHWAY 21",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338243",
            "telephone_number": "985-400-5566",
            "fax_number": "985-400-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Avenue F",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273634",
            "country_code": "US",
            "telephone_number": "985-730-6970",
            "fax_number": "985-730-6363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3688 Veterans Memorial Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394018246",
            "country_code": "US",
            "telephone_number": "601-554-7400",
            "fax_number": "601-554-7499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "128 Highland Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Picayune",
            "state": "MS",
            "postal_code": "394665578",
            "country_code": "US",
            "telephone_number": "601-554-7400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "HUONG",
        "middle_name": "TRAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-07-21",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901928",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP09238",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "70411 Highway 21",
            "city": "Covington",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704338243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hwallace3172655@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hwallace3172655@direct.casso.us.com",
            "address_1": "70411 Highway 21",
            "city": "Covington",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704338243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Walgreen Co (Walgreens #09645)
• Walk With Me Community Improvement Center
• Jennifer Walkenford, LAC-CCS, NCC
• Kassidy B Wall, FNP
• Anne Marie Wallace, LPC
• Kirsten N Wallace, N/A
• Marquita Diane Wallace
• Joshua K Walls, MD
• Michael E Walsh, MD
• Geneal Poynter Walters, CCC-SLP

• Family Nurse Practitioner in Covington, LA
• Providers in Covington, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.