JAILENE WALLACE, FNP-C

Nurse Practitioner - Family

Active Individual
NPI: 1891678702

Practice Address

712 BROAD ST
Providence, RI 02907

Phone: (401) 233-5060

Specialties

Specialty Code Primary License
Nurse Practitioner - Family 363LF0000X Yes APRN04646 (RI)
Family Medicine - Geriatric Medicine 207QG0300X No APRN04646 (RI)

Frequently Asked Questions

NPI 1891678702 is the National Provider Identifier for JAILENE WALLACE, FNP-C, a Nurse Practitioner - Family provider located in Providence, RI. This NPI was enumerated on July 29, 2025.
JAILENE WALLACE, FNP-C practices at 712 BROAD ST, Providence, RI 02907.

Quick Facts

NPI
1891678702
Type
Individual
Enumerated
Jul 29, 2025
Last Updated
Sep 15, 2025

Nearby Providers