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

Naomi Susan Wallace, NP

Individual provider Nurse Practitioner · NPI 1013699131

Naomi Susan Wallace, NP is a Nurse Practitioner in Tyler, Texas. Qualified in 2023, 3 years ago. Practices with Etmc Physician Group, Inc, a 376-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2023
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

912 S Fleishel Ave
Tyler, TX 75701-2018
Phone: (903) 592-6901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1128446 (TX)

Record details

NPI number1013699131
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 7, 2023
Last updated in NPPESAugust 7, 2023
Certification dateAugust 7, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Etmc Physician Group, Inc. — 376 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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