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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LISA LYNN WALLACE, RN

Active

LISA LYNN WALLACE, RN is a Neonatal Intensive Care Nurse healthcare provider located in JACKSONVILLE, Florida. NPI 1396403135 is currently active in the NPPES registry. Verify at CMS.

Neonatal Intensive Care Nurse · JACKSONVILLE, FL

Registration Details

NPI Number
1396403135
Provider Type
Individual
Gender
Female
NPI Issued
Nov 29, 2021 (4.7410170706026 yrs)
Last Updated
Nov 29, 2021
License
RN089537 (GA)

Practice Information

Address
800 PRUDENTIAL DR
JACKSONVILLE, FL, 322078211
Browse FL providers · Browse ZIP 32207
Phone
9042028000
Primary Specialty
Neonatal Intensive Care Nurse
163WN0002X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.