Individual
MRS. JENNIFER F. WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-2138
(901) 595-3842
Mailing address
262 DANNY THOMAS PLACE, MS 515, MEMPHIS, TN 38105-2729
(901) 595-2138
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
12627
TN
Other
Enumeration date
06/12/2007
Last updated
05/09/2016
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