person
Jesse Lee Wallace, RN,APRN
Critical Care Medicine Nurse Practitioner in Charlottesville, Virginia
NPI 1013697267

Jesse Lee Wallace is a Critical Care Medicine Nurse Practitioner based in Philadelphia, VA and is specialized in Critical Care Medicine. Jesse Lee Wallace practices in Charlottesville, VA and has the professional credentials of RN,APRN. The NPI Number for Jesse Lee Wallace is 1013697267 and holds a License No. 0024187479 (Virginia).

The current practice location address for Jesse Lee Wallace is 1215 Lee St, Charlottesville, VA and can be reached out via phone at 434-924-3627.

Location: 1215 Lee St, Charlottesville, VA, 19123-1869
person
Provider Profile Details
NPI Number
1013697267
Provider Name
Jesse Lee Wallace
Credential
RN,APRN
Provider Entity Type
Individual
Gender
Male
Address
1215 Lee St, Charlottesville, VA, 19123-1869
Phone Number
434-924-3627
Fax Number
Provider Enumeration Date
07/24/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NONE 01 NONE
institution
Provider Business Practice Location Address Details
Address
1215 Lee St
City
State
Zip
22908-0816
Phone Number
434-924-3627
Fax Number
person
Provider Business Mailing Address Details
Address
1215 Lee St
City
State
Zip
22908-0816
Phone Number
434-924-3627
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Critical Care Medicine
Taxonomy
License No.
0024187479 (Virginia)
Definition
Definition to come...
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