Wallace, Nichole G
Wallace, Nichole G is an individual health care provider with primary practice located at 13123 E 16Th Ave B390, Aurora CO 80045-7106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child Abuse Pediatrics, which is considered as her primary health care specialty. Wallace, Nichole G can be contacted via phone (303) 864-5250.Contact Information
Primary practice address
13123 E 16Th Ave B390
Aurora CO 80045-7106
Phone: (303) 864-5250
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Child Abuse Pediatrics | 2080C0008X | DR0054149 | Colorado |
Profile Details
| NPI number | 1497729909 |
|---|---|
| LBN Legal business name | Wallace, Nichole G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Dec 9th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497729909 | NPPES |
| Oklahoma | MEDICAID | 200020480B |
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