Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anabel Rafaela Disla Wallace, NP

Individual provider Family Nurse Practitioner · NPI 1487447231

Anabel Rafaela Disla Wallace, NP is a Nurse Practitioner in Philadelphia, Pennsylvania. Qualified in 2025, 1 year ago. Practices with Dedicated Pennsylvania Holding LLC, an 18-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
1
Licensed in
PA
In the registry since
2025
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

6431 Sackett St
Philadelphia, PA 19149
Phone: (267) 448-4908
Fax: (267) 297-3950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence SP032861 (PA)

Record details

NPI number1487447231
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedMay 26, 2025
Last updated in NPPESJuly 29, 2025
Certification dateJuly 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Dedicated Pennsylvania Holding Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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