Pamela Yvette Wallace, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

266271-1 Issued in NY

Practice address

360 Delaware Ave
Suite 310 Interim Healthcare
Buffalo, NY 14202-1620

Phone

(716) 852-5900

Fax

(716) 852-5913

NPI assigned

Apr 7, 2011

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": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1629367990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DELAWARE AVE",
            "address_2": "SUITE 310 INTERIM HEALTHCARE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021620",
            "telephone_number": "716-852-5900",
            "fax_number": "716-852-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DELAWARE AVE",
            "address_2": "SUITE 310 INTERIM HEALTHCARE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021620",
            "telephone_number": "716-852-5900",
            "fax_number": "716-852-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "PAMELA",
        "middle_name": "YVETTE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "266271-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Marie Walkowiak, LMHC
• Desiree Walkowski, LMSW
• Catherine Kelly Wallace
• Jhamal Wallace, MD
• Nicole Wallace, DC, AVCA
• Amanda Shirley Waller, COTA/L
• Alexandrea Wallgren, CRC
• Susan Walls
• Christopher Patrick Walsh, LMSW
• Evan Walsh

• Licensed Practical Nurse in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.