| Michael Wallis, NP | |
|
1634 Elton Rd, Jennings, LA 70546-3614 | |
| (800) 893-9698 | |
| Not Available |
| Full Name | Michael Wallis |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 20 Years |
| Location | 1634 Elton Rd, Jennings, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285050690 | NPI | - | NPPES |
| 2356003 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN112816 (Louisiana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pcp Urgent Care Holdings Llc | 5092016816 | 46 |
| Entity Name | Hospital Service District #1 Of East Baton Rouge Parish |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962437681 PECOS PAC ID: 0941191902 Enrollment ID: O20040322000429 |
| Entity Name | Jefferson Davis Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043289572 PECOS PAC ID: 2365496775 Enrollment ID: O20050309000285 |
| Entity Name | St Tammany Emergency Physicians Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891187654 PECOS PAC ID: 7214255967 Enrollment ID: O20150409001843 |
| Entity Name | Pcp Urgent Care Holdings Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245601038 PECOS PAC ID: 5092016816 Enrollment ID: O20151222000155 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Wallis, NP 200 Corporate Blvd, Suite 201, Lafayette, LA 70508-3870 Ph: () - | Michael Wallis, NP 1634 Elton Rd, Jennings, LA 70546-3614 Ph: (800) 893-9698 |
Christian Faith Lewis, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1322 Elton Rd, Suite P, Jennings, LA 70546 Phone: 337-824-2282 Fax: 337-824-0058 | |
Ms. Brandy Marie Heinrich, FNP BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1750 Elton Rd, Jennings, LA 70546 Phone: 337-329-6565 Fax: 337-329-6575 | |
Karen Lynn Golla, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 422 Kade Dr Ste 1, Jennings, LA 70546 Phone: 337-388-6200 Fax: 337-388-6201 | |
Amy Elizabeth Hulsey, APRN, WHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 805 State St, Jennings, LA 70546 Phone: 337-824-6150 | |
Mr. Damian Broussard, F.N.P Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1607 Johnson St, Jennings, LA 70546 Phone: 337-306-3251 | |
Nyra D Kershaw, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1750 Elton Rd, Jennings, LA 70546 Phone: 337-329-6565 | |
Jonathan Rochon, FNP-C, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1634 Elton Rd, Jennings, LA 70546 Phone: 337-616-7000 |