Individual provider · Type 1 NPI

Jason David Wallace

Psychiatric/Mental Health Nurse Practitioner · Jonesboro, AR

NPI number 1235755638 Active

Practice location

2214 Chesapeake Cv
Jonesboro, AR 72404-7104

Call (615) 618-6200 Map

Mailing address

2616 Gallaway Cv
Jonesboro, AR 72404-7827

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X125806 (AR)

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

Other psychiatric/mental health nurse practitioner providers in Jonesboro

See all in Jonesboro →

About NPI 1235755638

Jason David Wallace's National Provider Identifier is 1235755638, issued on Jun 22, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Jonesboro, AR. The record was last updated on May 14, 2025.