Susan Wallace
NPI 1104000199 · Adult Health Nurse Practitioner · Lutz, FL
Susan Wallace is a Adult Health Nurse Practitioner provider in Lutz, FL (NPI 1104000199).
Provider details
- NPI number
- 1104000199
- Entity type
- Individual
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- ARNP3262052 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-12-26
- Last updated
- 2007-12-26
Frequently asked questions
- What is Susan Wallace's NPI number?
- Susan Wallace's National Provider Identifier (NPI) is 1104000199, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Susan Wallace's specialty?
- Susan Wallace is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Susan Wallace located?
- Susan Wallace's practice location on file with NPPES is 17501 Dale Mabry Hwy N, Lutz, FL 33548-4521.
- What is Susan Wallace's phone number?
- The practice phone number listed in the NPPES registry for Susan Wallace is (813) 962-1000.
- Is Susan Wallace's NPI active?
- Yes — Susan Wallace's NPI (1104000199) is active in the NPPES registry as of the last update on 2007-12-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.