Individual
KATIE A WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16906
MA
225100000X
Physical Therapist
2972
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020481677
—
ME
01
—
08Y008383NH09
ANTHEM
NH
01
—
098440
ANTHEN
ME
01
—
101051400
US DEPT OF LABOR
NH
01
—
1297438
AETNA
NH
01
—
26206
CIGNA
NH
05
—
30394394
—
NH
01
—
3779390
CIGNA
NH
01
—
755459
TUFTS
NH
01
—
AA51239
HARVARD PILGRIM HEALTH
NH
Enumeration date
06/20/2006
Last updated
09/09/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up