Susan Wall, ARNP

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

3011271 Issued in KY

Practice address

800 Rose St
Lexington, KY 40536-4804

Phone

(859) 323-5962

NPI assigned

Jan 2, 2015

Last updated

Nov 13, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1720476575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 MONTCLAIR DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405364804",
            "telephone_number": "859-323-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "KY",
            "license": "3011271",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "FL",
            "license": "9207632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Walker, MS, OTR/L
• Victoria Lynn Walker, MD
• Kandace Marie Wall, APRN
• Margaret Wall
• Rebecca Wall, CRNA
• Amy M Wallace, APRN, NNP-BC
• Ato Wallace, MD
• Carmel Wallace Jr., MD
• Chelsea Cernosek Wallace, M.D.
• Derrick Paul Wallace

• Critical Care Pediatric Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Critical Care Pediatric Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.