Search › Minnesota › 363AS0400X
Heather Wallace, DSC., PA-C
NPI 1821342106 · on the registry since 2012
Practice
- Address
- 915 E 1st St
Duluth, MN 55805 - Phone
- (218) 249-6450
- Organisation at this address
- St. Luke'S Hospital
St. Luke'S Hospital Of Duluth
St. Luke'S Hospital Of Duluth
St. Luke'S Hospital Of Duluth
St. Luke'S Hospital Of DuluthInferred from a shared address, not stated in the registry. - Clinicians at this address
- 215
Additional practice sites
- 620 John Paul Jones Cir, Portsmouth, VA
- 3000 Arlington Ave Ste 2c, Toledo, OH
- 104 Union Ave, Syracuse, NY
- 301 Prospect Ave, Syracuse, NY
- 7101 Jahnke Rd, Richmond, VA
- 1100 Goethals Dr Ste E, Richland, WA
- 33-57 Harrison St, Johnson City, NY
- 1701 N Senate Blvd, Indianapolis, IN
- 5486 Indian River Rd, Virginia Beach, VA
Registry record
- Primary taxonomy
- 363AS0400X
363AS0400X
- Also registered as
- 363AS0400X
363A00000X
363AS0400X
363AS0400X
363A00000X
363A00000X
363AS0400X - Licence states on file
- WA, VA, MN, NY, NJ, IN, OH, IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-12-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota