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JACLYN RENEE WALLACE NNP-BC
NPI 1326572801
Nurse Practitioner - Neonatal, Critical Care in Atlanta, GA

Active since April 12, 2017
1711 TULLIE CIR NE, ATLANTA, GA 30329(404) 785-5413(404) 785-6233 Get Directions Write a Review

NPPES record last updated: April 12, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jaclyn Renee Wallace Nnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACLYN RENEE WALLACE NNP-BC (NPI 1326572801) is an individual neonatal, critical care provider in Atlanta, Georgia, licensed in Georgia (RN211895) and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1326572801
Entity TypeIndividualFemale
Primary Taxonomy363LN0005X
Provider Legal NameJACLYN RENEE WALLACECredential: NNP-BC
Location Address1711 TULLIE CIR NEAtlanta, GA 30329-2305
Mailing Address1711 Tullie Cir NeAtlanta, GA 30329-2305 · (404) 785-5413 · Fax (404) 785-6233
Phone(404) 785-5413
Fax(404) 785-6233
Sole ProprietorYes
Enumeration DateApril 12, 2017
✔ NPI 1326572801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Neonatal, Critical CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0005X
License✔ Licensed in GA · RN211895
1711 TULLIE CIR NE, Atlanta, GA 30329
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Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE GRUBER STEPHENSON NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
SPENCER LEE
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
SALINA PATEL
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
MS. JEANENE HILL BOWMAN NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
CAITLIN EZZELL
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
SONYA MCLAUGHLIN RN, NNP-BC
Nurse Practitioner
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-7283
MS. KATHERINE MCGINNIS NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-5413
TONYA R SELFRIDGE RN, NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
1711 TULLIE CIR NE
ATLANTA, GA 30329
Dekalb County (404) 785-7283

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jaclyn Wallace's NPI number?

The NPI number for Jaclyn Wallace is 1326572801. It was assigned to this individual provider in the NPPES registry on April 12, 2017.

Where is Jaclyn Wallace located?

Jaclyn Wallace practices at 1711 Tullie Cir NE, Atlanta, GA 30329. The listed phone number is (404) 785-5413.

What is Jaclyn Wallace's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, Critical Care, with taxonomy code 363LN0005X.

When was this NPI record last updated?

The NPPES record for Jaclyn Wallace was last updated on April 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.