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MR. MICHAEL ALAN WALLACE CNP
NPI 1003057852
Nurse Practitioner - Family in Albuquerque, NM

Active since March 07, 2009
8210 LOUISIANA BLVD NE, SUITE C, ALBUQUERQUE, NM 87113(505) 858-1222(505) 858-1224 Get Directions Write a Review

NPPES record last updated: March 11, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Michael Alan Wallace Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL ALAN WALLACE CNP (NPI 1003057852) is an individual family provider in Albuquerque, New Mexico, licensed in New Mexico (R48828) and active in the NPI registry since March 2009.

NPPES Registry Identity

NPI1003057852
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. MICHAEL ALAN WALLACECredential: CNP
Location Address8210 LOUISIANA BLVD NE, SUITE CAlbuquerque, NM 87113-1761
Mailing Address8210 Louisiana Blvd Ne, Suite CAlbuquerque, NM 87113-1761 · (505) 858-1222 · Fax (505) 858-1224
Phone(505) 858-1222
Fax(505) 858-1224
Sole ProprietorNo
Enumeration DateMarch 7, 2009
Last NPPES UpdateMarch 11, 2013
✔ NPI 1003057852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NM · R48828
8210 LOUISIANA BLVD NE, Albuquerque, NM 87113
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Other Identifiers 2

Medicaid29623341NM
Medicare PINNMA100469NM

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APRIL H VOLK MD
Internal Medicine
8210 LOUISIANA BLVD NE, C
ALBUQUERQUE, NM 87113
Bernalillo County (505) 858-1222
DR. VALERIE ANN WROBLEWSKI DDS
Dentist
8210 LOUISIANA BLVD NE, STE. A
ALBUQUERQUE, NM 87113
Bernalillo County (505) 881-3881

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Wallace's NPI number?

The NPI number for Michael Wallace is 1003057852. It was assigned to this individual provider in the NPPES registry on March 7, 2009.

Where is Michael Wallace located?

Michael Wallace practices at 8210 Louisiana Blvd NE Suite C, Albuquerque, NM 87113. The listed phone number is (505) 858-1222.

What is Michael Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Michael Wallace was last updated on March 11, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.