JAILENE WALLACE, FNP-C
Nurse Practitioner - Family
Active
Individual
NPI: 1891678702
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
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DR. GABRIELA MASKO, M.D.
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DR. NICKLAS OLDENBURG, M.D.
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RADIATION ONCOLOGY ASSOCIATES INC
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