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1699122820
JENA WALLACE
LENOIR, NC
NPI
1699122820
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: NC 253837)
Enumeration Date
2016-05-17
Last Update Date
2021-03-17
Business Address
JENA WALLACE
322 MULBERRY ST SW STE A
LENOIR, NC 28645-5703
Phone number: 828-757-6460
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Mailing Address
JENA WALLACE
1853 18TH STREET CT NE
HICKORY, NC 28601-0533
Phone number: 860-334-2475
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