Wallace-Marcelle, Caylynn Ann

Wallace-Marcelle, Caylynn Ann is an individual health care provider with primary practice located at 8441 Wayzata Blvd Ste 140, Golden Valley MN 55426-1366. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Wallace-Marcelle, Caylynn Ann can be contacted via phone (651) 769-6300.

Contact Information

Primary practice address
8441 Wayzata Blvd Ste 140 Golden Valley MN 55426-1366
Phone: (651) 769-6300
Fax: (651) 769-6349
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R180936-5 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1809365 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 955 Minnesota

Profile Details

NPI number 1861558835
LBN Legal business name Wallace-Marcelle, Caylynn Ann
Credentials ARNP, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Sep 13th, 2022 - about 2 years 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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Identifiers

StateTypeNumberIssuer
All States NPI 1861558835 NPPES
Minnesota MEDICAID 1861558835

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