Braden Jacob Wallace, PHARMD

Pharmacist · Santa Fe, NM

Individual Active NPI

NPI number 1114496973

Practice location

1700 Cerrillos Rd
Santa Fe, NM 87505-3026
Phone
(505) 946-9387

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NPI record

NPI
1114496973
Entity type
Individual (Type 1)
Enumeration date
November 21, 2018
Last updated
November 21, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacist Primary 183500000X 0022441 CO

Mailing address

3600 Cerrillos Rd Ste 732
Santa Fe, NM 87507-2689
Phone
(918) 989-6276

About Dr. Wallace

Braden Jacob Wallace, PHARMD is a healthcare provider registered in the NPI registry with the primary taxonomy Pharmacist (code 183500000X). The practice location is 1700 Cerrillos Rd, Santa Fe, NM 87505-3026. The NPI number 1114496973 was assigned on November 21, 2018 and the record was last updated on November 21, 2018.

Dr. Wallace lists a license in the registry: #0022441 (CO) for Pharmacist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Braden Jacob Wallace, PHARMD?

The NPI number is 1114496973.

What is the phone number of Dr. Wallace?

The phone number listed for the practice location is (505) 946-9387.

Where is Dr. Wallace located?

1700 Cerrillos Rd, Santa Fe, NM 87505-3026.

What is the taxonomy code for Dr. Wallace?

The primary taxonomy code is 183500000X – Pharmacist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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