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LISA LYNN WALLACE RN
NPI 1396403135
Registered Nurse - Neonatal Intensive Care in Jacksonville, FL

Active since November 29, 2021
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207(904) 202-8000 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lisa Lynn Wallace Rn NPPES

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

LISA LYNN WALLACE RN (NPI 1396403135) is an individual neonatal intensive care provider in Jacksonville, Florida, licensed in Georgia (RN089537) and active in the NPI registry since November 2021.

NPPES Registry Identity

NPI1396403135
Entity TypeIndividualFemale
Primary Taxonomy163WN0002X
Provider Legal NameLISA LYNN WALLACECredential: RN
Location Address800 PRUDENTIAL DRJacksonville, FL 32207-8211
Mailing Address546 Rocky Creek RdHampton, GA 30228-3071 · (678) 414-7809
Phone(904) 202-8000
Sole ProprietorNo
Enumeration DateNovember 29, 2021
NPPES CertifiedNovember 29, 2021
✔ NPI 1396403135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Neonatal Intensive CareNursing Service Providers
Taxonomy Code163WN0002X
License✔ Licensed in GA · RN089537
800 PRUDENTIAL DR, Jacksonville, FL 32207
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Other Providers at the Same Location NPPES 20

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

ERIN M SCHOLZ MS CCC-SLP
Speech-Language Pathologist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
TERRI TURNER TOMLINSON MSC CC-SLP
Speech-Language Pathologist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
MICHELLE SENIA ANTONIO PT
Physical Therapist
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
ELIZABETH ANN POSTUPACK NURSE PRACTITIONER
Nurse Practitioner (Neonatal)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 244-4242
ALYSSA KAY MOULDS CAA
Anesthesiologist Assistant
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
JAMEY MEDDERS CAA
Anesthesiologist Assistant
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000
DR. DAVID ANDREW HOLLOMAN MD
Pathology (Anatomic Pathology & Clinical Pathology)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (843) 323-8883
MR. BRADLEY JAMES WINE RN
Registered Nurse (Medical-Surgical)
800 PRUDENTIAL DR
JACKSONVILLE, FL 32207
Duval County (904) 202-2000

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 Lisa Wallace's NPI number?

The NPI number for Lisa Wallace is 1396403135. It was assigned to this individual provider in the NPPES registry on November 29, 2021.

Where is Lisa Wallace located?

Lisa Wallace practices at 800 Prudential Dr, Jacksonville, FL 32207. The listed phone number is (904) 202-8000.

What is Lisa Wallace's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Neonatal Intensive Care, with taxonomy code 163WN0002X.

When was this NPI record last updated?

The NPPES record for Lisa Wallace was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.