Wallace, Jessica

Wallace, Jessica is an individual health care provider with primary practice located at 580 Mohawk Dr , Boulder CO 80303-3712. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Licensed Practical Nurse, Nursing Service Providers / Registered Nurse. Nursing Service Providers / Registered Nurse is her primary health care specialty. Wallace, Jessica can be contacted via phone (303) 554-5185.

Contact Information

Primary practice address
580 Mohawk Dr Boulder CO 80303-3712
Phone: (303) 554-5185
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 41618 Colorado
Nursing Service Providers / Registered Nurse 163W00000X 185784 Colorado

Profile Details

NPI number 1184820565
LBN Legal business name Wallace, Jessica
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2007
Last updated May 2nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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