HATTIE WALLACE
NPI 1164796520
Licensed Practical Nurse in Phoenix, AZ

Q: What is Hattie Wallace's NPI number?

The NPI number for Hattie Wallace is 1164796520. It was assigned to this individual provider in the NPPES registry on March 2, 2012. The provider is also known as Hattie Lane Lpn.

Q: What is Hattie Wallace's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Hattie Wallace was last updated on March 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 March 02, 2012

14625 S MOUNTAIN PKWY, APT 1056, PHOENIX, AZ 85044(602) 565-2159 Get Directions Write a Review

NPPES record last updated: March 2, 2012. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Hattie Wallace NPPES

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

HATTIE WALLACE (NPI 1164796520) is an individual licensed practical nurse in Phoenix, Arizona, licensed in Arizona (LP044351) and active in the NPI registry since March 2012.

NPPES Registry Identity

NPI1164796520

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameHATTIE WALLACE

Location Address14625 S MOUNTAIN PKWY, APT 1056Phoenix, AZ 85044-7142

Mailing Address14625 S Mountain Pkwy, Apt 1056Phoenix, AZ 85044-7142 · (602) 565-2159

Phone(602) 565-2159

Sole ProprietorYes

Enumeration DateMarch 2, 2012

✔ NPI 1164796520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in AZ · LP044351

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

14625 S MOUNTAIN PKWY, Phoenix, AZ 85044

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Other Names 1

Former Name (1)Hattie Lane Lpn

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 Hattie Wallace's NPI number?

The NPI number for Hattie Wallace is 1164796520. It was assigned to this individual provider in the NPPES registry on March 2, 2012. The provider is also known as Hattie Lane Lpn.

Where is Hattie Wallace located?

Hattie Wallace practices at 14625 S Mountain Pkwy Apt 1056, Phoenix, AZ 85044. The listed phone number is (602) 565-2159.

What is Hattie Wallace's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Hattie Wallace was last updated on March 2, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.