Jessica Lynne Wallace
Nurse Practitioner - Neonatal (Critical Care)
1200 Pleasant St
Des Moines
, Iowa 50309-1453
Jessica Lynne Wallace
Nurse Practitioner - Neonatal (Critical Care)
1200 Pleasant St
Des Moines
, Iowa 50309-1453
(319) 899-9473
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About
Features
Specialties
- Nurse Practitioner - Neonatal (Critical Care)
Languages spoken
- English
Location
First Address
- Jessica Lynne Wallace
- 405 Se 17th Ct
- Grimes, IA
- Zip : 50111-6605
- Phone : (319) 899-9473
Second Address
- Jessica Lynne Wallace
- 1200 Pleasant St
- Des Moines, IA
- Zip : 50309-1453
- Phone : (515) 241-5437
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | K155915 | IA |
National Provider Identifier
| NPI | 1215581293 |
|---|---|
| Provider Name | Jessica Lynne Wallace |
| First Address | Grimes, IA 50111-6605 |
| Second Address | Des Moines, IA 50309-1453 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/07/2019 |
| Last Update Date | 29/07/2019 |
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.