EVELYN ADDO-WALLACE NP
NPI 1184965493
Nurse Practitioner - Women's Health in New York, NY

Q: What is Evelyn Addo-wallace's NPI number?

The NPI number for Evelyn Addo-wallace is 1184965493. It was assigned to this individual provider in the NPPES registry on March 12, 2013.

Q: What is Evelyn Addo-wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Active since March 12, 2013

165 BROADWAY FL 23, NEW YORK, NY 10006(888) 731-8994 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 1, 2024, Jun 22, 2024, May 14, 2024 and 1 more (4 updates tracked since 2019).

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About Evelyn Addo-wallace Np NPPES

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

EVELYN ADDO-WALLACE NP (NPI 1184965493) is an individual women's health provider in New York, New York, licensed in New York (F421131-1) and active in the NPI registry since March 2013. She maintains 3 additional practice locations.

NPPES Registry Identity

NPI1184965493

Entity TypeIndividualFemale

Primary Taxonomy363LW0102X

Provider Legal NameEVELYN ADDO-WALLACECredential: NP

Location Address165 BROADWAY FL 23New York, NY 10006-1452

Mailing Address1112 Regal Oak DrRockville, MD 20852-1048 · (917) 297-1980 · Fax (336) 900-1320

Phone(888) 731-8994

Sole ProprietorNo

Enumeration DateMarch 12, 2013

Last NPPES UpdateOctober 1, 20244 updates tracked since enumeration

NPPES CertifiedOctober 1, 2024

✔ NPI 1184965493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LW0102X

License✔ Licensed in NY · F421131-1

Also ListedRegistered Nurse · Women's Health Care, AmbulatoryTaxonomy 163WW0101X · License 659682-1 (NY)

165 BROADWAY FL 23, New York, NY 10006

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Secondary Practice Locations 3

Location 110440 Little Patuxent Pkwy Ste 300Columbia, MD 21044-3648 · Phone (888) 731-8994

Location 2111 N Orange Ave Ste 800Orlando, FL 32801-2381 · Phone (888) 731-8994

Location 3601 Pennsylvania Ave NW Bldg Suite900Washington, DC 20004-2601 · Phone (888) 731-8994

Other Identifiers 1

Medicaid00695941NY

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.

CASSANDRA STARK

Nurse Practitioner (Women's Health)