Morgan Eaton Wallace

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

NPWALL-XGP0W Issued in NC

Practice address

314 Buccaneer Rd
Wilmington, NC 28409-2719

Phone

(910) 538-4552

NPI assigned

Sep 28, 2021

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1952072076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 BUCCANEER RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284092719",
            "telephone_number": "910-538-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 BUCCANEER RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284092719",
            "telephone_number": "910-538-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "MORGAN",
        "middle_name": "EATON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "NPWALL-XGP0W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee V. Wall, PA-C
• Brooke Elizabeth Wallace, OTR/L
• Emma B. Wallace, LMFT
• John Wallace II, MD
• Leshonda Tequilla Wallace, FNP
• Stephen Curtis Wallace, D.D.S.,M.H.S.,P.A.
• Christina Clair Waller, LCSW
• Allan Todd Walls, DDS
• Walser Inc. D/B/a Avada Audiology
• Christin Lipscomb Walsh, CRNA

• Acute Care Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Acute Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.