Wallace, Jessica Dene
Wallace, Jessica Dene is an sole proprietor health care provider with primary practice located at 167 North Main Street , Tuba City AZ 86045-0600. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Wallace, Jessica Dene can be contacted via phone (928) 283-2501.Contact Information
Primary practice address
167 North Main Street
Tuba City AZ 86045-0600
Phone: (928) 283-2501
Fax: (928) 283-2677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | CNM278747 | Arizona |
Profile Details
| NPI number | 1760100028 |
|---|---|
| LBN Legal business name | Wallace, Jessica Dene |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2022 |
| Last updated | Aug 22nd, 2022 - about 3 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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