Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

CAMERON BLAKE WALLACE CRNA
NPI 1174456578
Nurse Anesthetist, Certified Registered in Charleston, WV

Q: What is Cameron Wallace's NPI number?

The NPI number for Cameron Wallace is 1174456578. It was assigned to this individual provider in the NPPES registry on June 4, 2026.

Q: What is Cameron Wallace's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Cameron Wallace was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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 June 04, 2026

3200 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-5432 Get Directions Write a Review

NPPES record added: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 3, 2026, Jun 4, 2026 (2 updates tracked since 2026).

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About Cameron Blake Wallace Crna NPPES

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

CAMERON BLAKE WALLACE CRNA (NPI 1174456578) is an individual nurse anesthetist, certified registered in Charleston, West Virginia, licensed in West Virginia (109296) and active in the NPI registry since June 2026.

NPPES Registry Identity

NPI1174456578

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameCAMERON BLAKE WALLACECredential: CRNA

Location Address3200 MACCORKLE AVE SECharleston, WV 25304-1227

Mailing Address4188 8th Street RdHuntington, WV 25701-9440

Phone(304) 388-5432

Sole ProprietorNo

Enumeration DateJune 4, 2026

Last NPPES UpdateAugust 3, 20262 updates tracked since enumeration

NPPES CertifiedAugust 3, 2026

✔ NPI 1174456578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in WV · 109296

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

3200 MACCORKLE AVE SE, Charleston, WV 25304

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Other Identifiers 1

Medicaid1174456578WV

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.

CAMERON DUBA DO

Emergency Medicine

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-4172

WILLIAM JARRETT WISEMAN BSN, RN, CCRN-CMC

Registered Nurse

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 993-1088

MS. BRENDA LOU KEEFER ANP

Nurse Practitioner (Family)

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 925-3436

LOUISE NAYLOR

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARSTON, WV 25304

Kanawha County (304) 388-4077

DR. JEFFREY V ASHLEY M.D.

Family Medicine

3200 MACCORKLE AVE SE, FIFTH FLOOR
CHARLESTON, WV 25304

Kanawha County (304) 388-4600

TIFFANY D. DUTTON CRNA

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE, DEPT. OF SURGERY
CHARLESTON, WV 25304

Kanawha County (304) 388-5503

JENNIFER D VALDEZ

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 388-5432

CHRISTOPHER S MULLINS

Nurse Anesthetist, Certified Registered

3200 MACCORKLE AVE SE
CHARLESTON, WV 25304

Kanawha County (304) 688-0228

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 Cameron Wallace's NPI number?

The NPI number for Cameron Wallace is 1174456578. It was assigned to this individual provider in the NPPES registry on June 4, 2026.

Where is Cameron Wallace located?

Cameron Wallace practices at 3200 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-5432.

What is Cameron Wallace's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Cameron Wallace was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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.