Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1992368872 Individual Practitioner Female Practitioner

Lisa Ann Wallace

Licensed Practical Nurse • Horton, MI

Professional Overview & Biography Verified Profile Summary

Lisa Wallace is a registered healthcare professional specializing in Licensed Practical Nurse in Horton, MI. Practice services are available at 8700 MOSHERVILLE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8700 Mosherville Rd

Horton, MI 492469601

Telephone 5173585830
Associated Practice Facility / Clinic
🏢 Care That Matters Facility NPI 1972371656

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Horton, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Horton, MI (4550 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-12-12
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License MI 4703086959

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location December 12, 2023

Registered at 8700 MOSHERVILLE RD, HORTON, MI 492469601 (Tel: 5173585830)

📍
Updated Business Mailing Address December 12, 2023

Registered at 8700 MOSHERVILLE RD, HORTON, MI 492469601 (Tel: 5173585830)

NPI Profile Active April 17, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location April 17, 2019

Registered at 27777 INKSTER RD, FARMINGTON HILLS, MI 483345326 (Tel: 2482364400)

📍
Updated Business Mailing Address April 17, 2019

Registered at 27777 INKSTER RD, FARMINGTON HILLS, MI 483345326 (Tel: 2482364400)

👤
Provider Name / Credentials Updated April 17, 2019

Recorded as LISA WALLACE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 17, 2019

Licensed Practical Nurse (License #4703086959 in MI)

🟢
Initial NPI Registration & Enumeration April 17, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992368872
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2019
Last Update: December 12, 2023
Sole Proprietor: No

Mailing Address

8700 Mosherville Rd

Horton, MI 492469601

Phone: 5173585830

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.