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

Andrea Nicole Wallace, FNP

Individual provider Nurse Practitioner · NPI 1417455809

Andrea Nicole Wallace, FNP is a Nurse Practitioner in Charlotte, North Carolina. Qualified in 2016, 10 years ago. Practices with Carolinas Physicians Network Inc, a 2,328-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
10
Licensed in
NC
In the registry since
2018
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

14214 Ballantyne Lake Rd Ste 100
Charlotte, NC 28277-3372
Phone: (704) 667-2650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 5717 Albemarle Rd, Charlotte, NC 28212-1634 — (704) 563-2150
  • 10210 Couloak Dr, Charlotte, NC 28216-7679 — (704) 801-2000
  • 7810 Providence Rd, Charlotte, NC 28226-2954 — (704) 543-6636
  • 5727 Prosperity Crossing Dr, Charlotte, NC 28269-2206 — (704) 863-9930

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 5010264 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence 5010264 (NC)

Record details

NPI number1417455809
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedJanuary 31, 2018
Last updated in NPPESJuly 15, 2024

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Carolinas Physicians Network Inc — 2328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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