SEAN WALLACE
NPI 1114321650
Nurse's Aide in Tuba City, AZ

Q: What is Sean Wallace's NPI number?

The NPI number for Sean Wallace is 1114321650. It was assigned to this individual provider in the NPPES registry on October 13, 2014.

Q: What is Sean Wallace's specialty?

The primary specialty registered for this NPI is Nurse's Aide with taxonomy code 376K00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Wallace was last updated on October 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 October 13, 2014

167 NORTH MAIN STREET, TUBA CITY, AZ 86045(928) 283-2501(928) 283-2677 Get Directions Write a Review

NPPES record last updated: October 13, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Sean Wallace NPPES

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

SEAN WALLACE (NPI 1114321650) is an individual nurse's aide in Tuba City, Arizona, licensed in Arizona (CNA1000037427) and active in the NPI registry since October 2014.

NPPES Registry Identity

NPI1114321650

Entity TypeIndividualMale

Primary Taxonomy376K00000X

Provider Legal NameSEAN WALLACE

Location Address167 NORTH MAIN STREETTuba City, AZ 86045-0600

Mailing AddressPo Box 600, Pfs Business OfficeTuba City, AZ 86045-0600 · (928) 283-2781 · Fax (928) 283-2677

Phone(928) 283-2501

Fax(928) 283-2677

Sole ProprietorNo

Enumeration DateOctober 13, 2014

✔ NPI 1114321650 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse's AideNursing Service Related Providers

Taxonomy Code376K00000X

License✔ Licensed in AZ · CNA1000037427

Definition

(1) An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient/client activities as delegated by the nurse; (2) An individual trained (either on-the-job or through a formal course generally of less than one year) and experienced in performing patient or client-care nursing tasks that do not require the skills of a specialist, technician, or professional. Examples of tasks performed by nurses aides include changing clothes, diapers, and beds; assisting patients to perform exercises or personal hygiene tasks, and supporting communication or social interaction. Specific education and credentials are not required for this work.

167 NORTH MAIN STREET, Tuba City, AZ 86045

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Other Providers at the Same Location NPPES 20

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

JIMMIE L TAYLOR RN

Registered Nurse (Ambulatory Care)