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1710920376
JACQUELINE WALLACE
PROVIDENCE, RI
NPI
1710920376
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: RI RN12564)
Enumeration Date
2006-06-13
Last Update Date
2008-07-25
Business Address
-- JACQUELINE WALLACE RN
530 N MAIN ST
PROVIDENCE, RI 02904-5762
Phone number: 401-276-4100
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Mailing Address
-- JACQUELINE WALLACE RN
528 N MAIN ST
PROVIDENCE, RI 02904-5757
Phone number:
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