LUCY-BERTHA WALLANG PA-C NPI 1538111539

NPI Information

  • NPI: 1538111539
  • Provider Name: LUCY-BERTHA WALLANG, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2675 MAIN ST W
    SNELLVILLE, GA
    ZIP 30078
  • Phone: (770) 866-5147

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NPI Details

Lucy-bertha Wallang, PA-C is a physician assistant in Snellville, GA with 26 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Lucy-bertha Wallang, PA-C NPI is 1538111539. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2675 MAIN ST W
SNELLVILLE, GA
ZIP 30078-161
Phone: (770) 866-5147

The NPI 1538111539 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/17/2006 and was last updated on 6/6/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical58593CALIFORNIANo
2363AM0700XPhysician AssistantMedical026102-01NEW YORKNo
3363AM0700XPhysician AssistantMedical9117305FLORIDANo
4363AM0700XPhysician AssistantMedical200001685DISTRICT OF COLUMBIANo
5363AM0700XPhysician AssistantMedical124154IOWANo
6363AM0700XPhysician AssistantMedical1131-23WISCONSINNo
7363AM0700XPhysician AssistantMedical004665GEORGIANo
8363A00000XPhysician Assistant004665GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1723874491AMEDICAIDGEORGIA
211143OTHERGEORGIABLUE CROSS BLUE SHIELD
3723874491BMEDICAIDGEORGIA
401076922OTHERGEORGIAAMERIGROUP
5333656OTHERGEORGIAWELLCARE
6723874491MEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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