Wallace, La' Taysia

Wallace, La' Taysia is an individual health care provider with primary practice located at 21 Penny Dr , Huntington Station NY 11746-3422. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Licensed Practical Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Wallace, La' Taysia can be contacted via phone (516) 850-9623.

Contact Information

Primary practice address
21 Penny Dr Huntington Station NY 11746-3422
Phone: (516) 850-9623
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 716807-1 New York
Nursing Service Providers / Licensed Practical Nurse 164W00000X 308886-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F383676-01 New York

Profile Details

NPI number 1114297074
LBN Legal business name Wallace, La' Taysia
Credentials MSN, RN, CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2012
Last updated Apr 2nd, 2024 - about 2 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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