Kala Denise Wallace, is a
Registered Nurse based in Clintwood, Virginia. Kala Denise Wallace is licensed to practice in Virginia (license number 0001247510) and her current practice location is
571 Blowing Rock Rd, Clintwood, Virginia. She can be reached at her office (for appointments etc.) via phone at
(276) 865-2009.
NPI number for Kala Denise Wallace is 1699630749 and her current mailing address is 571 Blowing Rock Rd, Clintwood, Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1699630749.
Provider's Profile
| Full Name | Kala Denise Wallace |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse |
|---|
| Location | 571 Blowing Rock Rd, Clintwood, Virginia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1699630749
- Provider Enumeration Date: 12/22/2025
- Last Update Date: 12/22/2025
Medical Identifiers
Medical identifiers for Kala Denise Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1699630749 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163W00000X | Registered Nurse | 0001247510 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kala Denise Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Kala Denise Wallace, 571 Blowing Rock Rd, Clintwood, VA 24228-6838 Ph: (276) 865-2009 | Kala Denise Wallace, 571 Blowing Rock Rd, Clintwood, VA 24228-6838 Ph: (276) 865-2009 |
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