EXCLUDEDPROVIDER
Individual Revocation

Mia Wallace

Fernandina Beach, FL 32034

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Mia Wallace of Fernandina Beach, FL is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of August 20, 2025.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Fernandina Beach, FL 32034
Exclusion date
August 20, 2025
Exclusion type
Revocation (1128b4)
Source dataset
May 2026

Record summary

Mia Wallace appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Fernandina Beach, Florida. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is August 20, 2025, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateAugust 20, 2025
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Fernandina Beach, FL 32034. The listed provider category is Individual - Licensed Health Care Service Provider. The listed specialty is Nurse / Nurses Aide.

Other excluded providers in Fernandina Beach, FL

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Fernandina Beach, FL address.

Ashley Blair Morgan Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded Apr 2024
Brandon Patrick Conn Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded Oct 2021
Kathleen Anne Kirby Individual Drug Felony
Fernandina Beach, FL · Felony conviction relating to controlled substance · Excluded Jul 2020
Victoria Morgan Altman Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded Oct 2018
Rebecca Jill Thomas Individual Felony Fraud
Fernandina Beach, FL · Felony conviction relating to health care fraud · Excluded Mar 2014
Amy Rainbolt Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded Feb 2012
Patricia A Verri Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded Dec 2011
Brad Alan Seidel Individual Revocation
Fernandina Beach, FL · License revocation, suspension, or surrender · Excluded May 2007

See all 12 excluded providers in Fernandina Beach →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More Excluded Individuals in Florida More Records in Fernandina Beach More Revocation Records