Jennifer Marie Wallace, NURSE PRACTITIONER
NPI #1790412591 in Deptford, New Jersey
Provider Information
- NPI Number
- 1790412591
- Entity Type
- Individual
- Name
- Jennifer Marie Wallace, NURSE PRACTITIONER
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Gerontology
- Credential
- NURSE PRACTITIONER
- Enumeration Date
- Aug 2, 2022
- Last Updated
- Aug 2, 2022
Practice Location
- Address
- 202 CABOT CT
- City
- Deptford
- State
- New Jersey
- ZIP Code
- 08096-5114
- Phone
- (856) 885-4579
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Gerontology — Gerontology |
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