Wallace, Sherita Danielle

Wallace, Sherita Danielle is an individual health care provider with primary practice located at 3514 Highway 39 N Ste A&B , Meridian MS 39301-1305. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Wallace, Sherita Danielle can be contacted via phone (601) 512-1310.

Contact Information

Primary practice address
3514 Highway 39 N Ste A&B Meridian MS 39301-1305
Phone: (601) 512-1310
Fax: (833) 984-3427
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 37389 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 3-002311 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 902938 Mississippi

Profile Details

NPI number 1225502412
LBN Legal business name Wallace, Sherita Danielle
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2019
Last updated Jul 29th, 2025 - about last year

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 1225502412 NPPES
Mississippi MEDICAID 00786527

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