Michelle Wallace, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

NP-07879 Issued in OH

Practice address

8350 E Kemper Rd Ste a
Cincinnati, OH 45249-1684

Phone

(513) 404-4166

NPI assigned

Mar 5, 2007

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

Enrolled in OH, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1699804641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 E KEMPER RD STE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491684",
            "telephone_number": "513-404-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 E KEMPER RD STE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452491684",
            "telephone_number": "513-404-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "NP-07879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Wallace, CRNA
• Melissa A. Wallace, D.O.
• Micah Wallace, CDCA
• Michael Wallace
• Michelle Wallace, DPT
• Molly Wallace, RD, LD
• Nikki Wallace, LPN
• Olivia Wallace, BA
• Robert P. Wallace, M.D.
• Sanchez Wallace

• Women's Health Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Women's Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.