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

Individual provider Certified Registered Nurse Anesthetist · NPI 1548439375

Lisa Marie Wallace, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Macon, Georgia. Qualified in 2007, 19 years ago. Practices with Dale Medical Center, a 30-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
19
Licensed in
AL
In the registry since
2008
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

777 Hemlock St
Macon, GA 31201-2102
Phone: (478) 633-1000
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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 1-097840 (AL)

Record details

NPI number1548439375
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedFebruary 26, 2008
Last updated in NPPESJune 5, 2015

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Dale Medical Center — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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