STACY WALLACE
NPI 1386264109
Driver in Toledo, OH
About Stacy Wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STACY WALLACE (NPI 1386264109) is an individual driver provider in Toledo, Ohio, licensed in Ohio (RX730744) and active in the NPI registry since April 2020.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
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 Stacy Wallace's NPI number?
The NPI number for Stacy Wallace is 1386264109. It was assigned to this individual provider in the NPPES registry on April 22, 2020.
Where is Stacy Wallace located?
Stacy Wallace practices at 324 Kenilworth Ave, Toledo, OH 43610. The listed phone number is (419) 810-0900.
What is Stacy Wallace's specialty?
The primary specialty registered for this NPI is Driver with taxonomy code 172A00000X.
When was this NPI record last updated?
The NPPES record for Stacy Wallace was last updated on April 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Stacy Wallace · NPI 1386264109
Driver provider in Toledo, Ohio. Individual provider, active in the CMS NPPES registry since April 22, 2020.
## Identity
- **NPI:** 1386264109 (Entity type: Individual)
- **Enumerated:** April 22, 2020
- **Primary specialty:** Driver · taxonomy 172A00000X
- **State license:** RX730744 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 324 KENILWORTH AVE, Toledo, OH 43610-1456
- **Phone:** (419) 810-0900
## Record status
- **NPPES last updated:** April 22, 2020
- **Other identifiers:** Medicaid 85052075 (OH)
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Source: [NPI Profile](https://npiprofile.com/npi/1386264109) · Data from the CMS NPPES public registry.