HEATHER A WALLACE, DSC., PA-C, Surgical DULUTH, MN

Contact Information

HEATHER A WALLACE, DSC., PA-C

915 E 1ST ST
DULUTH, MN 55805-2107

Phone: 218-249-6450
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Surgical	363AS0400X	97	Physician Assistant
Physician Assistant	363A00000X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for HEATHER A WALLACE · (Female)

NPI #	`1821342106`
Status	Active
Credentials	DSC., PA-C
Entity	Individual
Enumeration date	11/07/2012
Last updated	12/10/2025 - About 6 months ago
Sole proprietor ¹	No
Identifiers	IL License # 085.010935 IN License # 10004010A MN License # 15336 NJ License # 25MP00742200 NY License # 029464 OH License # 50.007882RX VA License # 0110004235 WA License # PA61359713 IN Medicaid 300077904 IN Other 233690187 MEDICARE PTAN
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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HEATHER A WALLACE, DSC., PA-C – NPI #1821342106Surgical

Contact Information

Specialty

Surgical

Physician Assistant

NPI Profile & details for HEATHER A WALLACE · (Female)

Reviews for HEATHER A WALLACE

HEATHER A WALLACE, DSC., PA-C – NPI #1821342106
Surgical