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

Andrea Wallace, FNP-C

Individual provider Family Nurse Practitioner · NPI 1497414213

Andrea Wallace, FNP-C is a Nurse Practitioner in Olive Branch, Mississippi. Qualified in 2021, 5 years ago. Practices with Stern Cardiovascular Center, PA, a 117-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
5
Licensed in
TN
In the registry since
2021
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

5041 Goswell Cv
Olive Branch, MS 38654-9189
Phone: (901) 517-2555
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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 30782 (TN)

Record details

NPI number1497414213
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedDecember 9, 2021
Last updated in NPPESJuly 6, 2023
Certification dateJuly 6, 2023
Mailing address5041 Goswell Cv, Olive Branch, MS 38654-9189

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Stern Cardiovascular Center, Pa — 117 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Olive Branch