Jean A. Wallace
Nurse Practitioner - Neonatal
300 Community Dr
Manhasset
, New York 11030-3816
Jean A. Wallace
Nurse Practitioner - Neonatal
300 Community Dr
Manhasset
, New York 11030-3816
(631) 549-1357
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Jean A. Wallace
- 130 Elmwood Dr
- Dix Hills, NY
- Zip : 11746-5658
- Phone : (631) 549-1357
Second Address
- Jean A. Wallace
- 300 Community Dr
- Manhasset, NY
- Zip : 11030-3816
- Phone : (516) 562-4665
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0000X | Nurse Practitioner - Neonatal | F350149 | NY |
National Provider Identifier
| NPI | 1144480088 |
|---|---|
| Provider Name | Jean A. Wallace |
| First Address | Dix Hills, NY 11746-5658 |
| Second Address | Manhasset, NY 11030-3816 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/06/2008 |
| Last Update Date | 13/06/2008 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.