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KIMBERLY WALLACE LPN
NPI 1750785622
Licensed Practical Nurse in Wampsville, NY

Active since October 21, 2014
138 NORTH COURT STREET, WAMPSVILLE, NY 13163(315) 366-2490 Get Directions Write a Review

NPPES record last updated: October 21, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kimberly Wallace Lpn NPPES

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

KIMBERLY WALLACE LPN (NPI 1750785622) is an individual licensed practical nurse in Wampsville, New York, licensed in New York (290441) and active in the NPI registry since October 2014.

NPPES Registry Identity

NPI1750785622
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameKIMBERLY WALLACECredential: LPN
Location Address138 NORTH COURT STREETWampsville, NY 13163
Mailing Address2401 Clark RdCanastota, NY 13032-4759 · (315) 396-8515
Phone(315) 366-2490
Sole ProprietorNo
Enumeration DateOctober 21, 2014
✔ NPI 1750785622 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 NY · 290441
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.
138 NORTH COURT STREET, Wampsville, NY 13163
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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.

STEPHANIE ANN THOMPSON
Social Worker (Clinical)
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MS. ALEXA BRAYMAN LMSW
Social Worker
138 NORTH COURT STREET, #7
WAMPSVILLE, NY 13163
Madison County (315) 366-2435
MISS ELENI KARAYIANNI M.A.
Counselor (Mental Health)
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
RUSSELL JAMES STEWART
Counselor (Addiction (Substance Use Disorder))
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
DR. SHANNON K BIRMINGHAM PSY D
Psychologist
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MR. GARY ROY ROBERTS CASAC
Counselor (Addiction (Substance Use Disorder))
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
MRS. STEPHANIE ANN ANDERSON LCSW
Social Worker
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327
AMINTHA M. SELVARAJAH PA-C
Physician Assistant
138 NORTH COURT STREET
WAMPSVILLE, NY 13163
Madison County (315) 366-2327

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 Kimberly Wallace's NPI number?

The NPI number for Kimberly Wallace is 1750785622. It was assigned to this individual provider in the NPPES registry on October 21, 2014.

Where is Kimberly Wallace located?

Kimberly Wallace practices at 138 North Court Street, Wampsville, NY 13163. The listed phone number is (315) 366-2490.

What is Kimberly 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 Kimberly Wallace was last updated on October 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.