Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Christian Alexander Wallace, PA-C

Individual provider Physician Assistant · NPI 1477201440

Christian Alexander Wallace, PA-C is a Physician Assistant in Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

507 N 17th St
Milwaukee, WI 53233
Phone: (414) 288-5688
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5111 (TN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477201440
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 17, 2022
Last updated in NPPESNovember 21, 2022
Certification dateNovember 21, 2022

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