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

Lori Sue Wallace, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1427609759

Lori Sue Wallace, FNP-BC is a Nurse Practitioner in Mount Orab, Ohio. Qualified in 2019, 7 years ago. Practices with Healthsource of Ohio Inc, a 56-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2019
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

150 Health Partners Cir
Mount Orab, OH 45154-8610
Phone: (937) 444-2514
Fax: (937) 444-4818
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.025720 (OH)

Record details

NPI number1427609759
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedSeptember 27, 2019
Last updated in NPPESApril 8, 2026
Certification dateApril 8, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Healthsource Of Ohio Inc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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