JELISA WALLACE

HUNTSVILLE, AL
NPI1649889478
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AL  F06200386)
Enumeration Date2020-07-28
Last Update Date2024-03-12
Business Address
JELISA WALLACE CRNP
101 SIVLEY RD SW
HUNTSVILLE, AL 35801-4421
Phone number: 256-265-1000
Mailing Address
JELISA WALLACE CRNP
2306 CUMBERLAND AVE SW
DECATUR, AL 35603-2611
Phone number: 256-466-5717
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