Wallace, La' Taysia
Wallace, La' Taysia is an individual health care provider with primary practice located at 21 Penny Dr , Huntington Station NY 11746-3422. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Licensed Practical Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Wallace, La' Taysia can be contacted via phone (516) 850-9623.Contact Information
Primary practice address
21 Penny Dr
Huntington Station NY 11746-3422
Phone: (516) 850-9623
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Registered Nurse | 163W00000X | 716807-1 | New York |
Nursing Service Providers / Licensed Practical Nurse | 164W00000X | 308886-1 | New York |
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | F383676-01 | New York |
Profile Details
NPI number | 1114297074 |
---|---|
LBN Legal business name | Wallace, La' Taysia |
Credentials | MSN, RN, CPNP-PC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 10th, 2012 |
Last updated | Apr 2nd, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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