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Jennifer Marie Wallace, NURSEPRACTITIONER
Gerontology Nurse Practitioner in Deptford, New Jersey
NPI 1790412591

Jennifer Marie Wallace is a Gerontology Nurse Practitioner based in West Orange, NJ and is specialized in Gerontology. Jennifer Marie Wallace practices in Deptford, NJ and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Jennifer Marie Wallace is 1790412591 and holds a License No. 26NJ01341100 (New Jersey).

The current practice location address for Jennifer Marie Wallace is 202 Cabot Ct, Deptford, NJ and can be reached out via phone at 856-885-4579.

Location: 202 Cabot Ct, Deptford, NJ, 07052-4403
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790412591
Provider Name
Jennifer Marie Wallace
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
202 Cabot Ct, Deptford, NJ, 07052-4403
Phone Number
856-885-4579
Fax Number
Provider Enumeration Date
08/02/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
202 Cabot Ct
City
Deptford
State
New Jersey
Zip
08096-5114
Phone Number
856-885-4579
Fax Number
person
Provider Business Mailing Address Details
Address
202 Cabot Ct
City
Deptford
State
New Jersey
Zip
08096-5114
Phone Number
856-885-4579
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
26NJ01341100 (New Jersey)
Definition
Definition to come...
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