Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Heather E Wallace

Individual provider Gerontology Nurse Practitioner · NPI 1053856427

Heather E Wallace is a Gerontology Nurse Practitioner in Macon, Georgia. Licensed in Georgia. Registered with an NPI since 2016.

Licensed in
GA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

535 Coliseum Dr
Macon, GA 31217-0104
Phone: (478) 972-0277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence RN197918 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN197918 (GA)

Record details

NPI number1053856427
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 21, 2016
Last updated in NPPESDecember 27, 2016

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