Wallace, Robin E.

Wallace, Robin E. is an individual health care provider with primary practice located at 6160 Kempsville Cir Ste 325A , Norfolk VA 23502-3933. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Wallace, Robin E. can be contacted via phone (757) 354-2885.

Contact Information

Primary practice address
6160 Kempsville Cir Ste 325A Norfolk VA 23502-3933
Phone: (757) 354-2885
Fax: (757) 917-5141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110002610 Virginia

Profile Details

NPI number 1942497631
LBN Legal business name Wallace, Robin E.
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2007
Last updated Sep 5th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1942497631 NPPES
Virginia Other -022 TRICARE/CHAMPUS
Virginia Other 10115900P TRICARE/CHAMPUS
Virginia MEDICAID 1942497631 TRICARE/CHAMPUS
Virginia MEDICAID 8101130 TRICARE/CHAMPUS
Virginia Other PAR TRICARE/CHAMPUS
Virginia Other PAR TRICARE/CHAMPUS

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