Individual provider · Type 1 NPI

Jarred E. Wallace, RN

Emergency Registered Nurse · Detroit, MI

NPI number 1710609045 Active

Practice location

4646 John R St
Detroit, MI 48201-1916

Call (313) 576-4436 Map

Mailing address

4618 Meigs Ave
Waterford, MI 48329-1819

Specialties and licenses

Taxonomy	Code	License
Emergency Registered Nurse Primary	163WE0003X	4704321978 (MI)

Emergency Registered Nurse: Definition to come...

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About NPI 1710609045

Jarred E. Wallace, RN's National Provider Identifier is 1710609045, issued on Sep 14, 2022. The primary taxonomy on file is Emergency Registered Nurse (163WE0003X), and the practice location is in Detroit, MI. The record was last updated on Oct 18, 2022.