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

Lisa Ann Wallace

Individual provider Licensed Practical Nurse · NPI 1992368872

Lisa Ann Wallace is a Licensed Practical Nurse in Horton, Michigan. Licensed in Michigan. Registered with an NPI since 2019.

Licensed in
MI
In the registry since
2019

Practice location Address checks out

8700 Mosherville Rd
Horton, MI 49246-9601
Phone: (517) 358-5830
Show map & directions

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

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 4703086959 (MI)

Record details

NPI number1992368872
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 17, 2019
Last updated in NPPESDecember 12, 2023
Certification dateDecember 12, 2023
Mailing address8700 Mosherville Rd, Horton, MI 49246-9601