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

Ladawna Rae Wallace, FNP

Individual provider Family Nurse Practitioner · NPI 1174478952

Ladawna Rae Wallace, FNP is a Nurse Practitioner in Show Low, Arizona. Qualified in 2025, 1 year ago. Practices with Your Family Practice Team PC, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
1
Licensed in
AZ
In the registry since
2026
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4951 S White Mountain Rd Bldg A
Show Low, AZ 85901-7827
Phone: (928) 532-3926
Fax: (928) 532-2159
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2051 Evergreen Ln, Show Low, AZ 85901-7928 — (928) 457-1200

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 227454 (AZ)

Record details

NPI number1174478952
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedFebruary 26, 2026
Last updated in NPPESJune 2, 2026
Certification dateJune 2, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Your Family Practice Team Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Show Low