Individual provider · Type 1 NPI

Jaclyn Renee Wallace, NNP-BC

Critical Care Neonatal Nurse Practitioner · Atlanta, GA

NPI number 1326572801 Active

Practice location

1711 Tullie Cir NE
Atlanta, GA 30329-2305

Call (404) 785-5413 Map

Fax (404) 785-6233

Specialties and licenses

TaxonomyCodeLicense
Critical Care Neonatal Nurse Practitioner Primary 363LN0005XRN211895 (GA)

Critical Care Neonatal Nurse Practitioner: Definition to come...

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About NPI 1326572801

Jaclyn Renee Wallace, NNP-BC's National Provider Identifier is 1326572801, issued on Apr 12, 2017. The primary taxonomy on file is Critical Care Neonatal Nurse Practitioner (363LN0005X), and the practice location is in Atlanta, GA. The record was last updated on Apr 12, 2017.