Individual provider · Type 1 NPI

Jessica A. Wallace, APRN, PMHNP

Psychiatric/Mental Health Nurse Practitioner · Janesville, WI

NPI number 1114579364 Active

Practice location

903 Mineral Point Ave
Janesville, WI 53548-2970

Fax (608) 756-0174

Other practice locations

  • 2825 Prairie Ave, Beloit, WI 53511-1844 · (608) 365-2709
  • 1000 Mineral Point Ave, Janesville, WI 53548-2940 · (608) 756-6508

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Registered Nurse 163WP0808X179176-130 (WI)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X9344-33 (WI)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1114579364

Jessica A. Wallace, APRN, PMHNP's National Provider Identifier is 1114579364, issued on Jul 9, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Janesville, WI. The record was last updated on Jul 9, 2019.