person
Mr. Jason David Wallace
Psychiatric/Mental Health Nurse Practitioner in Jonesboro, Arkansas
NPI 1235755638

Jason David Wallace is a Psychiatric/Mental Health Nurse Practitioner based in Jonesboro, AR and is specialized in Psychiatric/Mental Health. Jason David Wallace practices in Jonesboro, AR. The NPI Number for Jason David Wallace is 1235755638 and holds a License No. 125806 (Arkansas).

The current practice location address for Jason David Wallace is 2616 Gallaway Cv, Jonesboro, AR and can be reached out via phone at 615-618-6200.

Location: 2616 Gallaway Cv, Jonesboro, AR, 72404-7827
person
Provider Profile Details
NPI Number
1235755638
Provider Name
Jason David Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
2616 Gallaway Cv, Jonesboro, AR, 72404-7827
Phone Number
615-618-6200
Fax Number
Provider Enumeration Date
06/22/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2616 Gallaway Cv
City
State
Zip
72404-7827
Phone Number
615-618-6200
Fax Number
person
Provider Business Mailing Address Details
Address
2616 Gallaway Cv
City
State
Zip
72404-7827
Phone Number
615-618-6200
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
125806 (Arkansas)
Definition
Definition to come...
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