MS. SUSAN ANN WALLACE
NPI 1104000199
Nurse Practitioner - Adult Health in Lutz, FL

Q: What is Susan Wallace's NPI number?

The NPI number for Susan Wallace is 1104000199. It was assigned to this individual provider in the NPPES registry on December 26, 2007. The provider is also known as Ms. Susan Ann Hayman Arnp.

Q: What is Susan Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Susan Wallace was last updated on December 26, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 26, 2007

17501 DALE MABRY HWY N, LUTZ, FL 33548(813) 962-1000 Get Directions Write a Review

NPPES record last updated: December 26, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ms. Susan Ann Wallace NPPES

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

MS. SUSAN ANN WALLACE (NPI 1104000199) is an individual adult health provider in Lutz, Florida, licensed in Florida (ARNP3262052) and active in the NPI registry since December 2007.

NPPES Registry Identity

NPI1104000199

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMS. SUSAN ANN WALLACE

Location Address17501 DALE MABRY HWY NLutz, FL 33548-4521

Mailing Address17501 Dale Mabry Hwy NLutz, FL 33548-4521 · (813) 962-1000

Phone(813) 962-1000

Sole ProprietorYes

Enumeration DateDecember 26, 2007

✔ NPI 1104000199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in FL · ARNP3262052

17501 DALE MABRY HWY N, Lutz, FL 33548

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Other Names 1

Former Name (1)Ms. Susan Ann Hayman Arnp

Other Providers at the Same Location NPPES

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

KHAVIR AHMED SHARIEFF D.O.

General Practice

17501 DALE MABRY HWY N
LUTZ, FL 33548

Hillsborough County (813) 962-1000

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 Susan Wallace's NPI number?

The NPI number for Susan Wallace is 1104000199. It was assigned to this individual provider in the NPPES registry on December 26, 2007. The provider is also known as Ms. Susan Ann Hayman Arnp.

Where is Susan Wallace located?

Susan Wallace practices at 17501 Dale Mabry Hwy N, Lutz, FL 33548. The listed phone number is (813) 962-1000.

What is Susan Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Susan Wallace was last updated on December 26, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.