JACQUELYN C WALLANDER DNP CRNP NPI 1063180792

NPI Information

  • NPI: 1063180792
  • Provider Name: JACQUELYN C WALLANDER, DNP CRNP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 985 PRINCE FREDERICK BLVD
    SUITE 201
    PRINCE FREDERICK, MD
    ZIP 20678
  • Phone: (410) 414-5329

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NPI Details

Jacquelyn C Wallander, DNP CRNP is an adult health nurse practitioner in Prince Frederick, MD with 4 years of experience. Jacquelyn C Wallander, DNP CRNP NPI is 1063180792. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

985 PRINCE FREDERICK BLVD
SUITE 201
PRINCE FREDERICK, MD
ZIP 20678-492
Phone: (410) 414-5329
Fax: (410) 535-4850

The NPI 1063180792 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Professional service for multiple injections of allergen (HCPCS:95117)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
  • Blood test, comprehensive group of blood chemicals (HCPCS:80053)
  • Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Blood test, thyroid stimulating hormone (tsh) (HCPCS:84443)
  • Thyroxine (thyroid chemical), free (HCPCS:84439)
  • Hemoglobin a1c level (HCPCS:83036)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 8/30/2021 and was last updated on 8/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthR227415MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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