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MR. KENNETH WALTER WALLACE
NPI 1144078239
Student in an Organized Health Care Education/Training Program in Cleveland, OH

Active since May 13, 2024
11075 EAST BLVD, CLEVELAND, OH 44106(216) 368-2766 Get Directions Write a Review

NPPES record last updated: May 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kenneth Walter Wallace NPPES

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

MR. KENNETH WALTER WALLACE (NPI 1144078239) is an individual student in an organized health care education/training program in Cleveland, Ohio and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1144078239
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. KENNETH WALTER WALLACE
Location Address11075 EAST BLVDCleveland, OH 44106-5409
Mailing Address2300 Overlook Rd Apt 110Cleveland Heights, OH 44106-2346 · (717) 572-5619
Phone(216) 368-2766
Sole ProprietorNo
Enumeration DateMay 13, 2024
NPPES CertifiedMay 13, 2024
✔ NPI 1144078239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
11075 EAST BLVD, Cleveland, OH 44106
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Other Providers at the Same Location NPPES 4

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

MADISON POLLARD
Student in an Organized Health Care Education/Training Program
11075 EAST BLVD
CLEVELAND, OH 44106
Cuyahoga County (216) 368-2766
ZORA RAGLOW-DEFRANCO
Social Worker
11075 EAST BLVD
CLEVELAND, OH 44106
Cuyahoga County (216) 368-2766
NICOLE HATCHER
Student in an Organized Health Care Education/Training Program
11075 EAST BLVD
CLEVELAND, OH 44106
Cuyahoga County (216) 368-2766
KATHERINE MAITLAND BRACKEN-TAYLOR
Student in an Organized Health Care Education/Training Program
11075 EAST BLVD
CLEVELAND, OH 44106
Cuyahoga County (216) 368-2766

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 Kenneth Wallace's NPI number?

The NPI number for Kenneth Wallace is 1144078239. It was assigned to this individual provider in the NPPES registry on May 13, 2024.

Where is Kenneth Wallace located?

Kenneth Wallace practices at 11075 East Blvd, Cleveland, OH 44106. The listed phone number is (216) 368-2766.

What is Kenneth Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Kenneth Wallace was last updated on May 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.