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

Leshonda Tequilla Wallace, FNP

Individual provider Family Nurse Practitioner · NPI 1851403257

Leshonda Tequilla Wallace, FNP is a Nurse Practitioner in Wilmington, North Carolina. Qualified in 2004, 22 years ago. Practices with Novant Health Medical Group Coastal Region LLC, a 576-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Licensed in
NC
In the registry since
2006
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone: (910) 662-9300
Fax: (910) 662-9301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 5006194 (NC)

Record details

NPI number1851403257
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESAugust 26, 2025
Certification dateAugust 26, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Novant Health Medical Group Coastal Region Llc — 576 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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