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

Shawn Marie Wallace, CRNP

Individual provider Nurse Practitioner · NPI 1518430875

Shawn Marie Wallace, CRNP is a Nurse Practitioner in Flourtown, Pennsylvania. Qualified in 2018, 8 years ago. Licensed in Maryland and New Jersey.

Years since qualifying
8
Licensed in
MD, NJ
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

110 W Wissahickon Ave
Flourtown, PA 19031-1898
Phone: (215) 248-7804
Show map & directions

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

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence NJDCATEMP-006243 (NJ)
Nurse Practitioner Taxonomy 363L00000X · Licence R235002 (MD)

Record details

NPI number1518430875
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJanuary 9, 2019
Last updated in NPPESAugust 6, 2022
Certification dateAugust 6, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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