Individual
JENNY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
121 OLD SOLOMONS ISLAND RD, ANNAPOLIS, MD 21401-4367
(410) 224-3663
Mailing address
121 OLD SOLOMONS ISLAND RD, ANNAPOLIS, MD 21401-4367
(410) 224-3663
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R215037
MD
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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