Wallace, Jamie Marie

Wallace, Jamie Marie is an individual health care provider with primary practice located at 3311 Prescott Rd Suite 201, Alexandria LA 71301-3900. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Wallace, Jamie Marie can be contacted via phone (318) 442-6767.

Contact Information

Primary practice address
3311 Prescott Rd Suite 201 Alexandria LA 71301-3900
Phone: (318) 442-6767
Fax: (318) 441-1259
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X TEMP PERMIT Louisiana

Profile Details

NPI number 1255523346
LBN Legal business name Wallace, Jamie Marie
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2007
Last updated Aug 13th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255523346 NPPES
Louisiana MEDICAID APPLIED FOR

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