JESSICA BOWMAN WALLACE NP NPI 1619561321

NPI Information

NPI: 1619561321
Provider Name: JESSICA BOWMAN WALLACE, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ETOWAH EMERGENCY PHYSICIANS, LLC

PECOS Registration: Yes

Address:
253 COUNTY ROAD 766
CEDAR BLUFF, AL
ZIP 35959
Phone: (256) 899-9147
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Jessica Bowman Wallace, NP is a family nurse practitioner in Cedar Bluff, AL with 4 years of experience. Jessica Bowman Wallace, NP NPI is 1619561321. 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:

253 COUNTY ROAD 766
CEDAR BLUFF, AL
ZIP 35959-595
Phone: (256) 899-9147

The NPI 1619561321 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 enumeration date for this NPI number is 2/23/2021 and was last updated on 2/23/2021.

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
1	363LF0000X	Nurse Practitioner	Family	RN241671	GEORGIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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