Mrs Jessica Nicole Wallace, RN is a
Registered Nurse based in Middleport, Ohio. Mrs Jessica Nicole Wallace is licensed to practice in Ohio (license number SL987156) and her current practice location is
655 Front St, Middleport, Ohio. She can be reached at her office (for appointments etc.) via phone at
(740) 416-5643.
NPI number for Mrs Jessica Nicole Wallace is 1689846164 and her current mailing address is 655 Front St, Middleport, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1689846164.
Provider's Profile
Full Name | Mrs Jessica Nicole Wallace |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | 655 Front St, Middleport, Ohio |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1689846164
- Provider Enumeration Date: 03/25/2008
- Last Update Date: 03/25/2008
Medical Identifiers
Medical identifiers for Mrs Jessica Nicole Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689846164 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | SL987156 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jessica Nicole Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Jessica Nicole Wallace, RN 655 Front St, Middleport, OH 45760 Ph: (740) 416-5643 | Mrs Jessica Nicole Wallace, RN 655 Front St, Middleport, OH 45760 Ph: (740) 416-5643 |
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