Nicolette Curran Wallace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP241412 Issued in ME

Practice address

62 Main St
Skowhegan, ME 04976-1198

Phone

(207) 858-4844

NPI assigned

Aug 15, 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

Enrolled in ME

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicolette.wallace@spc.direct.rfgh.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Redington-Fairview General Hospital

  • Critical Access Hospital
  • Skowhegan, ME
  • NPI 1174549133
  Medicare reassignment NPD
• Redington-Fairview General Hospital

  • Rural Health Clinic/Center
  • Madison, ME
  • NPI 1851423008
  NPD

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1881426211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 OLDE SCHOOL LN UNIT 104",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761263",
            "telephone_number": "207-612-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MAIN ST",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761198",
            "telephone_number": "207-858-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "NICOLETTE",
        "middle_name": "CURRAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie B Wade, PT
• Anne M Wagner, LSW
• Wal-Mart Stores East LP
• Walgreen Eastern Co Inc
• Lucas Wallace, OT
• Ali M Ward
• Ken R Ward, PTA
• Loralie Lynn Washburn, PT
• Albert T Webb, PA-C
• Eddie L Welch

• Family Nurse Practitioner in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.