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AUTUMN RENEE WALLACE
NPI 1801629720
Student in an Organized Health Care Education/Training Program in Grand Rapids, MI

Active since August 26, 2024
2013 EASTCASTLE DR SE STE B, GRAND RAPIDS, MI 49508(616) 888-1120 Get Directions Write a Review

NPPES record last updated: August 26, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Autumn Renee Wallace NPPES

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

AUTUMN RENEE WALLACE (NPI 1801629720) is an individual student in an organized health care education/training program in Grand Rapids, Michigan and active in the NPI registry since August 2024.

NPPES Registry Identity

NPI1801629720
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameAUTUMN RENEE WALLACE
Location Address2013 EASTCASTLE DR SE STE BGrand Rapids, MI 49508-8873
Mailing Address2013 Eastcastle Dr Se Ste BGrand Rapids, MI 49508-8873
Phone(616) 888-1120
Sole ProprietorNo
Enumeration DateAugust 26, 2024
NPPES CertifiedAugust 25, 2024
✔ NPI 1801629720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2013 EASTCASTLE DR SE STE B, Grand Rapids, MI 49508
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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.

KELSEY KAYLENE GRAY
Counselor (Mental Health)
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120
MISS KHALIDHA DAVIS
Student in an Organized Health Care Education/Training Program
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120
PATRICK EARL HILLARY
Counselor
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120
KATHRYN CHAPMAN-TURMO
Student in an Organized Health Care Education/Training Program
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120
BRANDI REDD
Psychologist (Counseling)
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120
RICHARD MICHAEL BECKER
Psychologist
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 204-0308
OLIVIA BRINGARD
Student in an Organized Health Care Education/Training Program
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (989) 285-9122
EMILY FORTINO
Student in an Organized Health Care Education/Training Program
2013 EASTCASTLE DR SE STE B
GRAND RAPIDS, MI 49508
Kent County (616) 888-1120

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 Autumn Wallace's NPI number?

The NPI number for Autumn Wallace is 1801629720. It was assigned to this individual provider in the NPPES registry on August 26, 2024.

Where is Autumn Wallace located?

Autumn Wallace practices at 2013 Eastcastle Dr SE Ste B, Grand Rapids, MI 49508. The listed phone number is (616) 888-1120.

What is Autumn Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Autumn Wallace was last updated on August 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.