| Dylan Elizabeth Wallace, FNP | |
|
3400 Spruce St, Philadelphia, PA 19104-4238 | |
| (215) 662-3920 | |
| Not Available |
| Full Name | Dylan Elizabeth Wallace |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 3400 Spruce St, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316569353 | NPI | - | NPPES |
| NA | Other | N/A |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | SP021955 (Pennsylvania) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medstar Medical Group Ii Llc | 0547413825 | 2998 |
| Medstar Urgent Care Llc | 9335303155 | 262 |
| Entity Name | Medstar Medical Group Ii Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184046187 PECOS PAC ID: 0547413825 Enrollment ID: O20130117000415 |
| Entity Name | Medstar Urgent Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871843409 PECOS PAC ID: 9335303155 Enrollment ID: O20130513000540 |
| Mailing Address | Practice Location Address |
|---|---|
| Dylan Elizabeth Wallace, FNP 3400 Spruce St, Philadelphia, PA 19104-4238 Ph: () - | Dylan Elizabeth Wallace, FNP 3400 Spruce St, Philadelphia, PA 19104-4238 Ph: (215) 662-3920 |
Ms. Nicole Marie Koepke, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3401 Civic Center Blvd, Children's Hospital Of Philadelphia - Emergency Med, Philadelphia, PA 19104 Phone: 215-590-1944 Fax: 215-590-4454 | |
Kathleen Ellen Kearney, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3535 Market St, Suite 100, Philadelphia, PA 19104 Phone: 215-746-3535 Fax: 215-746-1032 | |
Liza Thomas, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3400 Civic Center Boulevard, West Pavilion 3rd Floor, Philadelphia, PA 19104 Phone: 215-662-2891 | |
Mr. Charles E Warrington Jr., CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1100 Walnut St Fl 7, Medical Office Building, Philadelphia, PA 19107 Phone: 215-955-2165 Fax: 215-923-7957 | |
Carley Bober, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 34th Street And Civic Center Blvd, Cardiac Center At Chop, Philadelphia, PA 19104 Phone: 215-590-6051 Fax: 215-590-1340 | |
Ms. Candyce S Dorsey, CRNP, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1408 S Broad St, Philadelphia, PA 19146 Phone: 215-755-0700 | |
Ling Fan, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 111 S 11th St, Gibbon Bldg., Suite 6270, Philadelphia, PA 19107 Phone: 215-955-8304 |