Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Mrs. Phyllis A Wallace, APRN

Family Nurse Practitioner in Konawa, OK · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1366486417

Verified

See something wrong? Report a correction

Registry record

Entity type Individual (Type 1)

Name Mrs. Phyllis A Wallace

Credential APRN

Sex Female

Practice address 527 W 3rd St, Konawa, OK, 74849

Phone (580) 925-3286

Fax (580) 925-9149

Enumeration date Jun 16, 2006

Last updated in NPPES Nov 22, 2021

Taxonomy & licenses

363LW0102X Women's Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License R0035497 (OK) Secondary

363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 35497 (OK) Primary

APRN · Advanced Practice Registered Nurse: An umbrella credential covering NPs, CRNAs, CNMs, and clinical nurse specialists. About the APRN credential

Other identifiers

Identifier	Type	State	Issuer
100155800A	Medicaid	OK	-
100155800B	Other	OK	SOONERCARE PROVIDER

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Phyllis Wallace practice?

The practice location on file with NPPES is in Konawa, OK. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Phyllis Wallace?

The National Provider Identifier (NPI) for Phyllis Wallace is 1366486417, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

Browse all →

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-11-22.