IndividualActive
Nichole Wallace, MD
NPI 1497729909 · Child Abuse Pediatrics Physician · Aurora, CO
Provider details
- NPI number
- 1497729909
- Entity type
- Individual
- Primary specialty
- Child Abuse Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- DR0054149 (CO)
Mailing address
Po Box 110429
Aurora, CO 80042-0429
Registry dates
- Enumerated
- 2006-02-14
- Last updated
- 2014-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.