BERNICE E WALLACE
NPI 1679887707
Nurse Practitioner - Pediatrics in Plantation, FL

Active since July 30, 2010
4101 NW 4TH ST, SUITE 200, PLANTATION, FL 33317(954) 791-5420(954) 791-5950 Get Directions Write a Review

NPPES record last updated: February 16, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bernice E Wallace NPPES

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

BERNICE E WALLACE (NPI 1679887707) is an individual pediatrics provider in Plantation, Florida, licensed in Florida (ARNP1772012) and active in the NPI registry since July 2010.

NPPES Registry Identity

NPI1679887707
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameBERNICE E WALLACE
Location Address4101 NW 4TH ST, SUITE 200Plantation, FL 33317-2850
Mailing Address4101 Nw 4th St, Suite 200Plantation, FL 33317-2850 · (954) 791-5420 · Fax (954) 791-5950
Fax(954) 791-5950
Sole ProprietorNo
Enumeration DateJuly 30, 2010
Last NPPES UpdateFebruary 16, 2012
NPI 1679887707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in FL · ARNP1772012
4101 NW 4TH ST, Plantation, FL 33317

Other Identifiers 1

Medicaid302604300FL

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.

Specialist
4101 NW 4TH ST, SUITE 404
PLANTATION, FL 33317
Chiropractor
4101 NW 4TH ST, #208
PLANTATION, FL 33317
Internal Medicine
4101 NW 4TH ST, SUITE 109
PLANTATION, FL 33317
Nurse Practitioner (Obstetrics & Gynecology)
4101 NW 4TH ST, SUITE 306
PLANTATION, FL 33317
Nurse Practitioner
4101 NW 4TH ST, SUITE 404
PLANTATION, FL 33317
Registered Nurse (Obstetric, High-Risk)
4101 NW 4TH ST, SUITE 306
PLANTATION, FL 33317
Internal Medicine
4101 NW 4TH ST, STE 109
PLANTATION, FL 33317
Non-Pharmacy Dispensing Site
4101 NW 4TH ST, #208
PLANTATION, FL 33317

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 Bernice Wallace's NPI number?

The NPI number for Bernice Wallace is 1679887707. It was assigned to this individual provider in the NPPES registry on July 30, 2010.

Where is Bernice Wallace located?

Bernice Wallace practices at 4101 NW 4th St Suite 200, Plantation, FL 33317. The listed phone number is (954) 791-5420.

What is Bernice Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

When was this NPI record last updated?

The NPPES record for Bernice Wallace was last updated on February 16, 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.