MS. Jessica Elizabeth Wallace, NURSE PRACTITIONER
NPI #1215981170 in Manhattan Beach, California
Provider Information
- NPI Number
- 1215981170
- Entity Type
- Individual
- Name
- MS. Jessica Elizabeth Wallace, NURSE PRACTITIONER
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Registered Nurse
- Credential
- NURSE PRACTITIONER
- Enumeration Date
- May 22, 2006
- Last Updated
- Dec 19, 2019
Practice Location
- Address
- 2200 N SEPULVEDA BLVD
- City
- Manhattan Beach
- State
- California
- ZIP Code
- 90266-2910
- Phone
- (310) 802-0200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
| Nurse Practitioner - Family — Family |
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