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

Mr. Cory Wallace, MSN, AGPCNP-BC

Individual provider Nurse Practitioner · NPI 1255066411

Mr. Cory Wallace, MSN, AGPCNP-BC is a Geriatric Medicine in Somerset, New Jersey. Qualified in 2025, 1 year ago. Licensed in New Jersey.

Years since qualifying
1
Licensed in
NJ
In the registry since
2022
Specialties on file
2
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

See every abbreviation used in this directory →

Practice location Address checks out

27 Clyde Rd Ste 102
Somerset, NJ 08873-5039
Phone: (732) 246-0057
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 26NJ15461200 (NJ)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence 26NR20435100 (NJ)

Record details

NPI number1255066411
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN , AGPCNP-BC
Sole proprietorNo
NPI enumeratedJuly 21, 2022
Last updated in NPPESMarch 9, 2026
Certification dateMarch 9, 2026

Medicare enrollment

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

Medicare specialtyGERIATRIC MEDICINE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Somerset