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

Kathleen Wallace, APN

Individual provider Nurse Practitioner · NPI 1225035504

Kathleen Wallace, APN is a Nurse Practitioner in Merrillville, Indiana. Qualified in 1987, 39 years ago. Practices with Nephrology Associates of Northern Indiana PC, a 64-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
39
Licensed in
IN
In the registry since
2005
What do these letters mean?
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

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Practice location Address checks out

90 W 86th Ave
Merrillville, IN 46410-7086
Phone: (219) 791-1555
Fax: (219) 791-1560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71000826A (IN)

Record details

NPI number1225035504
Entity typeIndividual (Type 1)
GenderFemale
Credentials APN
Sole proprietorNo
NPI enumeratedJuly 1, 2005
Last updated in NPPESDecember 13, 2022
Certification dateDecember 13, 2022
Mailing address120 W 22nd St Ste 200, Oak Brook, IL 60523-1563

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice Nephrology Associates Of Northern Indiana Pc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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