Individual provider · Type 1 NPI

Jacquelyn C. Wallander, DNP CRNP

Adult Health Nurse Practitioner · Prince Frederick, MD

NPI number 1063180792 Active

Practice location

985 Prince Frederick Blvd, Suite 201
Prince Frederick, MD 20678-3492

Fax (410) 535-4850

Mailing address

985 Prince Frederick Blvd Suite 201
Prince Frederick, MD 20678-3492

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200XR227415 (MD)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1063180792

Jacquelyn C. Wallander, DNP CRNP's National Provider Identifier is 1063180792, issued on Aug 30, 2021. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Prince Frederick, MD. The record was last updated on Aug 30, 2021.