IndividualActive
Laura Wallace, CNM
NPI 1679047005 · Advanced Practice Midwife · Stockbridge, GA
Provider details
- NPI number
- 1679047005
- Entity type
- Individual
- Primary specialty
- Advanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CNM
- Sex
- Female
- Sole proprietor
- No
- License
- RN067198 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 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
115 Eagle Spring Dr Ste A200
Stockbridge, GA 30281-6486
Phone: (770) 474-0064
Fax: (770) 474-2998
Street-level locationGet directions
Mailing address
115 Eagle Spring Dr Ste A200
Stockbridge, GA 30281-6486
Registry dates
- Enumerated
- 2019-01-18
- Last updated
- 2019-01-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.