JESSICA WALLACE (NPI# 1245577907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245577907 |
Entity Type | Individual |
Full Name | JESSICA WALLACE |
Practice Address |
6175 Hickory Flat Hwy Suite 140 Canton GA 30115-7207 |
Practice Telephone | 7703458606 |
Mailing Telephone | 7703458606 |
Enumeration Date | 2013-01-14 |
Last Update Date | 2013-01-14 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | RPH026896 | GA | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871089680 | Jessica Renee Wallace | Nurse Practitioner | 1821 E. High St., Springfield, OH 45505 | 2018-07-04 |
1821517210 | Jessica Wallace | Behavioral Analyst | 43835 Timber Sq Unit 203, Leesburg, VA 20176-3432 | 2017-09-17 |
1548639560 | Jessica Ann Wallace | Physician Assistant | 1890 Us Highway 131 Unit 4, Petoskey, MI 49770-8344 | 2015-09-21 |
1285031682 | Jessica Wallace | Speech-Language Pathologist | 2900 Knox School Rd, Alliance, OH 44601-9021 | 2014-12-01 |
1073940888 | Jessica Wallace | Marriage & Family Therapist | 15611 Pomerado Rd Ste 535, Poway, CA 92064-2437 | 2013-10-11 |
1659637478 | Jessica Lynn Wallace | Community/Behavioral Health | 26652 Muse Road, Muse, OK 74949 | 2012-04-05 |
1669751418 | Jessica Leigh Wallace | Physical Therapist | 224 Old River Rd, Bluffton, SC 29909-3952 | 2011-08-11 |
1689846164 | Jessica Nicole Wallace | Registered Nurse | 655 Front St, Middleport, OH 45760 | 2008-03-25 |
1710507371 | Jessica M Wallace | Nurse Anesthetist, Certified Registered | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-04-23 |
1306483359 | Jessica Wallace | Behavior Technician | 3130 S Durango Dr Ste 425, Las Vegas, NV 89117-4455 | 2019-12-09 |
Street Address |
6175 HICKORY FLAT HWY SUITE 140 |
City | CANTON |
State | GA |
Zip Code | 30115-7207 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194343970 | Vittorio Paradiso | Pharmacist | 6175 Hickory Flat Hwy, Canton, GA 30115-7207 | 2020-07-08 |
1225470727 | Lindsey Jo Edwards | Pharmacist | 6175 Hickory Flat Hwy, Ste 140, Canton, GA 30115-7207 | 2013-07-24 |
1326386608 | Jessica Smith | Pharmacist | 6175 Hickory Flat Hwy, Canton, GA 30115-7207 | 2013-01-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
Find all providers in zip 30115 |
Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
1467084343 | Syed Ashraf Ali Shah | Pharmacist | 385 Westbourne Ct, Canton, MI 48188-4718 | 2020-02-07 |
1427680503 | Gracy Mathai-mathews | Pharmacist | 770 Pheasant Woods Dr, Canton, MI 48188-5224 | 2020-02-06 |
1962059378 | Catherine Lynn Denner | Pharmacist | 330 Oak Hill Ln, Canton, GA 30115-5433 | 2019-08-20 |
1427601806 | Tarek Mazloum | Pharmacist | 3815 Herbey St, Canton, MI 48188-2421 | 2019-07-24 |
1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
1063978260 | Jordan Richard Wanner | Pharmacist | 4615 Middlebranch Ave Ne, Canton, OH 44705-2960 | 2019-02-13 |
1861972333 | Brittany Carin Yu | Pharmacist | 2512 Tuscarawas St W, Canton, OH 44708-4702 | 2018-08-15 |
1598256364 | Austin Tull | Pharmacist | 2260 Holly Springs Pkwy Ste 180, Canton, GA 30115-9580 | 2018-05-28 |
1518491513 | Jerry Sherwin Vidis | Pharmacist | 41092 Northwind Dr, Canton, MI 48188-3115 | 2017-04-17 |
Find all providers in CANTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.