person
Jennifer Lea Wallace, PAC
Surgical Physician Assistant in Saint Petersburg, Florida
NPI 1700864493

Jennifer Lea Wallace is a Surgical Physician Assistant based in Saint Petersburg, FL and is specialized in Surgical. Jennifer Lea Wallace practices in Saint Petersburg, FL and has the professional credentials of PAC. The NPI Number for Jennifer Lea Wallace is 1700864493 and holds a License No. PA9105134 (Florida).

The current practice location address for Jennifer Lea Wallace is 625 6Th Ave S, Saint Petersburg, FL and can be reached out via phone at 727-553-7100 and via fax at 727-553-7198.

Location: 625 6Th Ave S, Saint Petersburg, FL, 33701-4662
person
Provider Profile Details
NPI Number
1700864493
Provider Name
Jennifer Lea Wallace
Credential
PAC
Provider Entity Type
Individual
Gender
Female
Address
625 6Th Ave S, Saint Petersburg, FL, 33701-4662
Phone Number
727-553-7100
Fax Number
727-553-7198
Provider Enumeration Date
01/04/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
625 6Th Ave S
City
State
Zip
33701-4662
Phone Number
727-553-7100
Fax Number
727-553-7198
person
Provider Business Mailing Address Details
Address
625 6Th Ave S
City
State
Zip
33701-4662
Phone Number
727-553-7100
Fax Number
727-553-7198
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA9105134 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA9105134 (Florida)
Definition
Definition to come...
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