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

Individual provider Certified Registered Nurse Anesthetist · NPI 1184667388

Deborah A Wallace, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Lawrenceville, Georgia. Qualified in 1985, 41 years ago. Accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
41
Licensed in
GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1000 Medical Center Blvd
Lawrenceville, GA 30046-0000
Phone: (770) 277-3056
Fax: (855) 204-5244
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence RN040043 (GA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence R040043 (GA)

Record details

NPI number1184667388
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 14, 2006
Last updated in NPPESApril 29, 2014
Mailing addressPo Box 551420, Fort Lauderdale, FL 33355-1420

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 1985 (41 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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