Elizabeth Nicole Wallis
MD | Pediatrics | Female
Elizabeth Nicole Wallis, MD is a Gonzales, Louisiana based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Elizabeth Nicole Wallis is
1937 S Burnside Ave, Gonzales, Louisiana - 70737-4632. She can be contacted on phone at
225-765-5500 and fax number 225-644-9286.
Elizabeth Nicole Wallis is a sole proprietor of her business.
NPI number (Unique professional ID) for Elizabeth Nicole Wallis is
1821551334 which was assigned by NPPES on 11 Apr, 2019 and it was last updated on 11 Apr, 2023.
Elizabeth Nicole Wallis license number is
331615 for Pediatrics (208000000X) in Louisiana.
Elizabeth Nicole Wallis is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Elizabeth Nicole Wallis basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Elizabeth Nicole Wallis |
|---|
| Credential : | MD |
|---|
| Gender : | Female |
|---|
Business Address:
Elizabeth Nicole Wallis address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1937 S Burnside Ave
Gonzales, LA, 70737-4632
United States |
|---|
| Phone Number : | 225-765-5500 |
|---|
| Fax Number : | 225-644-9286 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1821551334 |
|---|
| NPI Entity Type : | Individual |
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| First Enrolment Date : | 11 Apr, 2019 |
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| Last Updated On : | 11 Apr, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Elizabeth Nicole Wallis are as mentioned. Primary taxonomy code for Elizabeth Nicole Wallis, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | No | | LA |
| 208000000X | Pediatrics | Yes | 331615 | LA |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
7777 HENNESSY BLVD STE 6004,
BATON ROUGE, LA, 70808-4300
United States | BATON ROUGE, LA | 225-765-3368 |
7777 HENNESSY BLVD STE 6004,
BATON ROUGE, LA, 70808-4300
United States | BATON ROUGE, LA | 225-765-3368 |
8415 GOODWOOD BLVD STE 100,
BATON ROUGE, LA, 70806-7851
United States | BATON ROUGE, LA | 225-765-5500 |
17609 OLD JEFFERSON HWY STE A,
PRAIRIEVILLE, LA, 70769-3980
United States | PRAIRIEVILLE, LA | 225-647-2511 |
14225 HIGHWAY 73,
PRAIRIEVILLE, LA, 70769-3616
United States | PRAIRIEVILLE, LA | 225-765-5500 |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | ewallis552569@direct.casso.us.com
FMOLHS-Epic | No affiliation | DIRECT
Direct
| OTHER
Other
ewallis552569@direct.casso.us.com | 1937 S Burnside Ave,
Gonzales, LA, 70737-4632
United States |
FHIR
(FHIR URL) | https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
FMOLHS FHIR URL | No affiliation | OTHER
Other
FHIR API | OTHER
Other
C-CDA | 1937 S Burnside Ave,
Gonzales, LA, 70737-4632
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 5959 S Sherwood Forest Blvd
Baton Rouge, LA, 70816-6038
United States |
|---|
| Phone Number : | 225-765-5500 |
|---|
| Fax Number : | 225-765-9196 |
|---|
Business Location:
Patients can refer following map for directions to
Elizabeth Nicole Wallis practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.