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Kathleen Wallace, APN
Nurse Practitioner in Merrillville, Indiana
NPI 1225035504

Kathleen Wallace is a Nurse Practitioner based in Oak Brook, IN. Kathleen Wallace practices in Merrillville, IN and has the professional credentials of APN. The NPI Number for Kathleen Wallace is 1225035504 and holds a License No. 71000826A (Indiana).

The current practice location address for Kathleen Wallace is 90 W 86Th Ave, Merrillville, IN and can be reached out via phone at 219-791-1555 and via fax at 219-791-1560.

Location: 90 W 86Th Ave, Merrillville, IN, 60523-1563
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225035504
Provider Name
Kathleen Wallace
Credential
APN
Provider Entity Type
Individual
Gender
Female
Address
90 W 86Th Ave, Merrillville, IN, 60523-1563
Phone Number
219-791-1555
Fax Number
219-791-1560
Provider Enumeration Date
07/01/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000331131 01 IN ANTHEM BCBS NUMBER
100082060 05 IN
200280140B 05 IN
500012853 01 IN RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
90 W 86Th Ave
City
Merrillville
State
Indiana
Zip
46410-7086
Phone Number
219-791-1555
Fax Number
219-791-1560
person
Provider Business Mailing Address Details
Address
90 W 86Th Ave
City
Merrillville
State
Indiana
Zip
46410-7086
Phone Number
219-791-1555
Fax Number
219-791-1560
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
71000826A (Indiana)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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