Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER LEA WALLACE, PAC
ActiveJENNIFER LEA WALLACE, PAC is a Medical Physician Assistant healthcare provider located in SAINT PETERSBURG, Florida. NPI 1700864493 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · SAINT PETERSBURG, FL
Registration Details
- NPI Number
- 1700864493
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 4, 2006 (20.591599499172 yrs)
- Last Updated
- Oct 8, 2015
- Licenses
-
PA9105134 (FL)PA9105134 (FL)
Practice Information
- Address
-
625 6TH AVE SSUITE 385SAINT PETERSBURG, FL, 337014662Browse FL providers · Browse ZIP 33701
- Phone
- 7275537100
- Fax
- 7275537198
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Surgical Physician Assistant
Other Medical Physician Assistant Providers in SAINT PETERSBURG, FL
| Name | Credential | NPI |
|---|---|---|
| SHERRI JUBAY | PA | 1831155035 |
| MS. LORI MICHELLE DELISLE | PA-C | 1740327600 |
| MRS. COURTNEY CALI TITUS | PA-C | 1598043390 |
| RYAN TROUP | PA-C | 1821415951 |
| KATRINA POTITHAVORANANT | — | 1710348479 |
| COLETTE R RAINE | PA-C | 1679197495 |
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.