Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum
Kathryn Mary Wallace, APRN, BC
Nurse Practitioner in Portage, IN · enumerated 2006.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1407965320
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Registry record
Entity type Individual (Type 1)
Name Kathryn Mary Wallace
Credential APRN, BC
Sex Female
Practice address 2640 Hamstrom Rd, Portage, IN, 46368
Phone (219) 762-4423
Fax (219) 763-3120
Enumeration date Aug 30, 2006
Last updated in NPPES Sep 17, 2012
Taxonomy & licenses
363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers · License 71000473A (IN) 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 |
|---|---|---|---|
| 200056120A | Medicaid | IN | - |
| 500004228 | Other | IN | RAILROAD MEDICARE |
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.
Frequently asked questions
What specialty is Kathryn Wallace?
Kathryn Wallace is registered in NPPES with the primary taxonomy of Nurse Practitioner. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.
Is this the official NPI registry?
No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.
Other providers at this practice address
Browse all → Shreyas Desai Internal Medicine Physician · Portage, IN NPI 1386646529 Internal Medicine,Geriatrics and Oncology Group, P.C. Internal Medicine Physician · Portage, IN NPI 1417983537 Faizuddin Shareef Family Medicine Physician · Portage, IN NPI 1891980462 Havishakrishna Sarma Internal Medicine Physician · Portage, IN NPI 1992934020 Gayle Voight-Block Family Nurse Practitioner · Portage, IN NPI 1861799090 New Beginnings Suboxone Treatment, LLC Corp Internal Medicine Physician · Portage, IN NPI 1114315041 Christina Connelly Family Nurse Practitioner · Portage, IN NPI 1750739702 Shaleena Gates Family Nurse Practitioner · Portage, IN NPI 1700553906
Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-09-17.