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

Stephanie Mary Wallace, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639304736

Stephanie Mary Wallace, MD is an Anesthesiology in Appleton, Wisconsin. Graduated from Medical College of Wisconsin in 2009, 17 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group and accepts Medicare assignment. Licensed in Maine and Wisconsin.

Years since qualifying
17
Trained at
Medical College of Wisconsin
Licensed in
ME, WI
In the registry since
2009
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1506 S Oneida St
Appleton, WI 54915-1305
Phone: (920) 738-2611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 60446 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (ME)

Record details

NPI number1639304736
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 19, 2009
Last updated in NPPESOctober 26, 2023
Certification dateOctober 26, 2023

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2009 (17 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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