JESSE LEE WALLACE

CHARLOTTESVILLE, VA
NPI1013697267
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LC0200X Nurse Practitioner, Critical Care Medicine
(Licence: VA  0024187479)
Enumeration Date2023-07-24
Last Update Date2023-07-24
Business Address
JESSE LEE WALLACE RN, APRN
1215 LEE ST
CHARLOTTESVILLE, VA 22908-0816
Phone number: 434-924-3627
Mailing Address
JESSE LEE WALLACE RN, APRN
1115 GERMANTOWN AVE UNIT 2A
PHILADELPHIA, PA 19123-1869
Phone number: 252-886-0066
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