JESSICA WALLACE

BOULDER, CO
NPI1184820565
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
(Licence: CO  185784)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: CO  41618)
Enumeration Date2007-06-22
Last Update Date2008-05-02
Business Address
-- JESSICA WALLACE
580 MOHAWK DR
BOULDER, CO 80303-3712
Phone number: 303-554-5185
Mailing Address
-- JESSICA WALLACE
580 MOHAWK DR
BOULDER, CO 80303-3712
Phone number: