Emily Elizabeth Wallace

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

R096399 Issued in AR

Practice address

5205 Bryant PL
Springdale, AR 72764-2588

Phone

(501) 413-7582

NPI assigned

Jun 24, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1619711744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 BRYANT PL",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642588",
            "telephone_number": "501-413-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 BRYANT PL",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727642588",
            "telephone_number": "501-413-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "AR",
            "license": "R096399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Walker
• Ladonna Walker
• Taylor Walker, LPC
• Laramie Wall, PHARMD
• Carolyn Ann Wallace, PTA
• Payton A Wallace, MSW
• Mary June Walls
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.

• Pediatric Registered Nurse in Springdale, AR
• Providers in Springdale, AR by specialty
• Pediatric Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.