Search › Georgia › 363LN0005X
Jaclyn Wallace, NNP-BC
NPI 1326572801 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1711 Tullie Cir Ne
Atlanta, GA 30329 - Phone
- (404) 785-5413
- Fax
- (404) 785-6233
- Clinicians at this address
- 12
Registry record
- Primary taxonomy
- 363LN0005X
363LN0005X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-04-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia