Colleen Wallace
Colleen Wallace is a Nurse Practitioner in Umatilla, Florida. Qualified in 2020, 6 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Florida.
- Years since qualifying
- 6
- Licensed in
- FL
- In the registry since
- 2021
Practice location Address checks out
287 S Central AveUmatilla, FL 32784-8411
Phone: (352) 747-0747
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Medicine Physician (primary) | Taxonomy 207QA0505X · Licence 11011114 (FL) |
|---|
Record details
| NPI number | 1992394423 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | January 11, 2021 |
| Last updated in NPPES | January 21, 2021 |
| Certification date | January 21, 2021 |
| Mailing address | Po Box 2485, Umatilla, FL 32784-2485 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |