Amanda Denise Wallace, NP

Family Nurse Practitioner · Brandon, FL

Individual Active NPI

NPI number 1275104796

Practice location

214 Morrison Rd Ste 104
Brandon, FL 33511-4849
Phone
(813) 681-6474
Fax
(813) 654-8473

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NPI record

NPI
1275104796
Entity type
Individual (Type 1)
Enumeration date
July 6, 2021
Last updated
June 30, 2022
Certified
June 30, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Family Nurse Practitioner Primary 363LF0000X 11013133 FL

Mailing address

214 Morrison Rd
Ste 104
Brandon, FL 33511-4849
Phone
(813) 681-6474
Fax
(813) 654-8473

Other practice locations (1)

  • 2590 Healing Way Ste 310, Wesley Chapel, FL 33543-5497 · (813) 333-1186

About Amanda Wallace

Amanda Denise Wallace, NP is a healthcare provider registered in the NPI registry with the primary taxonomy Family Nurse Practitioner (code 363LF0000X). The practice location is 214 Morrison Rd Ste 104, Brandon, FL 33511-4849. The NPI number 1275104796 was assigned on July 6, 2021 and the record was last updated on June 30, 2022.

Amanda Wallace lists a license in the registry: #11013133 (FL) for Family Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Amanda Denise Wallace, NP?

The NPI number is 1275104796.

What is the phone number of Amanda Wallace?

The phone number listed for the practice location is (813) 681-6474.

Where is Amanda Wallace located?

214 Morrison Rd Ste 104, Brandon, FL 33511-4849.

What is the taxonomy code for Amanda Wallace?

The primary taxonomy code is 363LF0000X – Family Nurse Practitioner.

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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