JACLYN RENEE WALLACE

ATLANTA, GA
NPI1326572801
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LN0005X Nurse Practitioner Neonatal, Critical Care
(Licence: GA  RN211895)
Enumeration Date2017-04-12
Last Update Date2017-04-12
Business Address
JACLYN RENEE WALLACE NNP-BC
1711 TULLIE CIR NE
ATLANTA, GA 30329-2305
Phone number: 404-785-5413
Mailing Address
JACLYN RENEE WALLACE NNP-BC
1711 TULLIE CIR NE
ATLANTA, GA 30329-2305
Phone number: 404-785-5413
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