Wallace, Katie Justine

Wallace, Katie Justine is an individual health care provider with primary practice located at Mashpee Family Medicine 5 Industrial Drive Suite 100, Mashpee MA 02649. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Wallace, Katie Justine can be contacted via phone (508) 477-4282.

Contact Information

Primary practice address
Mashpee Family Medicine 5 Industrial Drive Suite 100 Mashpee MA 02649
Phone: (508) 477-4282
Fax: (508) 539-6134
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN2264353 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN2264353 Massachusetts

Profile Details

NPI number 1790151967
LBN Legal business name Wallace, Katie Justine
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2015
Last updated Jan 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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