BRADEN JACOB WALLACE PHARMD
NPI 1114496973
Pharmacist in Santa Fe, NM

Active since November 21, 2018
1700 CERRILLOS RD, SANTA FE, NM 87505(505) 946-9387 Get Directions Write a Review

NPPES record last updated: November 21, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Braden Jacob Wallace Pharmd NPPES

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

BRADEN JACOB WALLACE PHARMD (NPI 1114496973) is an individual pharmacist in Santa Fe, New Mexico, licensed in Colorado (0022441) and active in the NPI registry since November 2018.

NPPES Registry Identity

NPI1114496973
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameBRADEN JACOB WALLACECredential: PHARMD
Location Address1700 CERRILLOS RDSanta Fe, NM 87505-3026
Mailing Address3600 Cerrillos Rd Ste 732Santa Fe, NM 87507-2689 · (918) 989-6276
Sole ProprietorNo
Enumeration DateNovember 21, 2018
NPI 1114496973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in CO · 0022441
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

1700 CERRILLOS RD, Santa Fe, NM 87505

Other Identifiers 1

OtherPHA.0022441CO · Pharmacist License Number

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.

Pharmacist
1700 CERRILLOS RD
SANTA FE, NM 87505
Optometrist
1700 CERRILLOS RD
SANTA FE, NM 87505
Pediatrics
1700 CERRILLOS RD
SANTA FE, NM 87505
Optometrist
1700 CERRILLOS RD
SANTA FE, NM 87505
Optometrist
1700 CERRILLOS RD
SANTA FE, NM 87505
Pharmacist
1700 CERRILLOS RD
SANTA FE, NM 87505
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
1700 CERRILLOS RD
SANTA FE, NM 87505
Pharmacist (Ambulatory Care)
1700 CERRILLOS RD
SANTA FE, NM 87505

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 Braden Wallace's NPI number?

The NPI number for Braden Wallace is 1114496973. It was assigned to this individual provider in the NPPES registry on November 21, 2018.

Where is Braden Wallace located?

Braden Wallace practices at 1700 Cerrillos Rd, Santa Fe, NM 87505. The listed phone number is (505) 946-9387.

What is Braden Wallace's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Braden Wallace was last updated on November 21, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.