JENNIFER WALLACE, PAC
Physician Assistant - Medical
Active
Individual
NPI: 1700864493
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant - Medical | 363AM0700X | Yes | PA9105134 (FL) |
| Physician Assistant - Surgical | 363AS0400X | No | PA9105134 (FL) |
Frequently Asked Questions
NPI 1700864493 is the National Provider Identifier for JENNIFER WALLACE, PAC, a Physician Assistant - Medical provider located in Saint Petersburg, FL. This NPI was enumerated on January 4, 2006.
JENNIFER WALLACE, PAC practices at 625 6TH AVE S, SUITE 385, Saint Petersburg, FL 33701.
Quick Facts
- NPI
- 1700864493
- Type
- Individual
- Enumerated
- Jan 4, 2006
- Last Updated
- Oct 8, 2015
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