- Practice location
- 59 Bangor St, Houlton, ME 04730-1740
- Phone
- 207-538-3700
- Fax
- 207-528-2880
- Last updated
- September 9, 2020
Desiree M Wallace is a Nurse's Aide based in Houlton, ME. Desiree M Wallace practices in Houlton, ME and has the professional credentials of CNA. The NPI Number for Desiree M Wallace is 1093364853 and holds a License No. cna67685 (ME). The current practice location address for Desiree M Wallace is 59 Bangor St, Houlton, ME 04730-1740 and can be reached out via phone at 207-538-3700 and via fax at 207-528-2880.
Provider Profile Details
- NPI Number
- 1093364853
- Provider Name
- Desiree M Wallace
- Credential
- CNA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 59 Bangor St, Houlton, ME 04730-1740
- Phone Number
- 207-538-3700
- Fax Number
- 207-528-2880
- Primary Taxonomy
- Nurse's Aide · 376K00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- September 5, 2019
- Last Update Date
- September 9, 2020
- Certification Date
- September 9, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 59 Bangor St
Houlton, ME 04730-1740 - City
- Houlton
- State
- Maine
- Zip
- 04730-1740
- Phone Number
- 207-538-3700
- Fax Number
- 207-528-2880
Provider Business Mailing Address Details
- Address
- 529 S Patten RD
Patten, ME 04765-3007 - City
- Patten
- State
- ME
- Zip
- 04765-3007
- Phone Number
- 207-538-3700
- Fax Number
- 207-528-2880
License Information
- License Number
- cna67685
- License State
- ME
- Taxonomy
- Nurse's Aide · 376K00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nurse's Aide providers near Houlton, ME
View all Nurse's Aide providers in Houlton →Frequently Asked Questions
What is the NPI number of Desiree M Wallace, CNA?
The NPI number of Desiree M Wallace, CNA is 1093364853. It was assigned on September 5, 2019 and is currently active in the NPPES registry.
What is the specialty of Desiree M Wallace, CNA?
Desiree M Wallace, CNA is registered under the primary taxonomy Nurse's Aide (code 376K00000X), licensed in ME under license number cna67685.
Where does Desiree M Wallace, CNA practice?
The practice location is 59 Bangor St, Houlton, ME 04730-1740. The office can be reached at 207-538-3700 (phone) or 207-528-2880 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1093364853 directly on the NPPES registry website.