JENNIFER L WALLACE (NPI# 1417185513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417185513 |
| Entity Type | Individual |
| Full Name | JENNIFER L WALLACE |
| Credential | RN |
| Practice Address |
1493 Cambridge St Cambridge MA 02139-1047 |
| Practice Telephone | 6176651560 |
| Practice Fax Number | 6176651843 |
| Mailing Telephone | 6176651560 |
| Mailing Fax Number | 6176651843 |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2009-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
RN233633 | MA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968440 | Jennifer Wallace | Technician/Technologist | 2041 E 3rd Dr, Mesa, AZ 85204-1401 | 2020-07-06 |
| 1497249882 | Jennifer Laird Wallace | Licensed Practical Nurse | 4468 Duff Rd, Livingston, TX 77351-5627 | 2018-06-19 |
| 1124579602 | Jennifer Marie Wallace | Acupuncturist | 237 Avenida Del Norte, Redondo Beach, CA 90277-5702 | 2016-10-19 |
| 1174926984 | Jennifer Wallace | Specialist/Technologist | 806 Patton Chapel Trl, Hoover, AL 35226-2254 | 2014-10-07 |
| 1295083897 | Jennifer Wallace | Psychologist | 4226 Green Lake Rd, West Bloomfield, MI 48323-1139 | 2012-08-29 |
| 1669799086 | Jennifer Renea Wallace | Counselor | 3802 W University Blvd Apt 8104, Durant, OK 74701-3047 | 2010-04-24 |
| 1306035431 | Jennifer L Wallace | Physical Therapist | 3891 50th Ave S, Saint Petersburg, FL 33711-4811 | 2007-10-15 |
| 1316974058 | Jennifer Wallace | Speech-Language Pathologist | 1901 Century Blvd Ne Ste 20, Atlanta, GA 30345-3300 | 2006-06-27 |
| 1992766570 | Jennifer P Wallace | Specialist | 64400 E 26th Ct, Byers, CO 80103-8539 | 2006-03-31 |
| 1730154154 | Jennifer Lyn Wallace | Family Medicine | 1235 Se Division St, Suite 208, Portland, OR 97202-1099 | 2006-02-20 |
| Street Address |
1493 CAMBRIDGE ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02139-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871590950 | Blake Cady | Surgery | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2005-07-05 |
| 1144821349 | Christina Marie Harris | Speech-Language Pathologist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-11-04 |
| 1558961128 | Rose M Jacob | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-31 |
| 1174122360 | Emilee Grace Abraham | Speech-Language Pathologist | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-10-20 |
| 1790384964 | Jillian Christine Fernandez | Occupational Therapist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-20 |
| 1447859624 | Ryan J Wallace | Pharmacist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-20 |
| 1376141606 | Angela Gonzalez | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-10-09 |
| 1669079646 | Ashley Simmons | Occupational Therapist | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-10-03 |
| 1831706159 | Valerie Anne Roberson | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1099 | 2020-09-30 |
| 1578170809 | Deborah Lee Trujillo | Licensed Practical Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2020-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598316044 | Diane Greenleaf | Registered Nurse | Cha Windsor Clinic, 119 Windsor St, Cambridge, MA 02139 | 2019-09-26 |
| 1730738345 | Martin Bednar | Student in an Organized Health Care Education/Training Program | 350 Massachusetts Avenue, Cambridge, MA 02139 | 2019-09-06 |
| 1861050049 | Rebecca Marie Addison | Dietitian, Registered | 75 Auburn St, Cambridge, MA 02139 | 2019-06-03 |
| 1285103051 | Jenna Halloran | Social Worker | 929 Massaschusetts Ave, Cambridge, MA 02139 | 2018-11-21 |
| 1750859286 | Lisa Marie Keovongsa | Dietitian, Registered | 186 1/2 Hampshire St., Cambridge, MA 02139 | 2018-11-02 |
| 1245714237 | Eleanor Coffin | Occupational Therapist | 1483 Cambridge St, Cambridge, MA 02139 | 2018-09-17 |
| 1649758277 | Sariya Idriss | Social Worker | Cambridge Health Alliance, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1538647151 | Ari Pehkonen | Social Worker | Cambridge Health Alliance, Cambridge Hospital, 1493 Cambridge St., Cambridge, MA 02139 | 2018-08-06 |
| 1972080893 | Esther Cazeau | Counselor | 237 Hampshire St., Cambridge, MA 02139 | 2018-07-24 |
| 1528596533 | Adam Liebling | Acupuncturist | 11 Fiske Pl., Cambridge, MA 02139 | 2017-06-03 |
| Find all providers in zip 02139 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619577756 | Jessica M Kinney | Registered Nurse | 841 Steubenville Ave, Cambridge, OH 43725-2301 | 2020-10-28 |
| 1982168191 | Joseph Lavoie | Registered Nurse | 875 Massachusetts Ave Ste 84, Cambridge, MA 02139 | 2019-01-22 |
| 1780124925 | Katlyn Dawn Dailey | Registered Nurse | 841 Steubenville Ave, Cambridge, OH 43725-2301 | 2017-03-07 |
| 1831560747 | Lesleigh Berg | Registered Nurse | 841 Steubenville Ave, Cambridge, OH 43725-2301 | 2015-10-19 |
| 1821347865 | Kathryn Marie Kahn | Registered Nurse | 1611 Cambridge St, Cambridge, MA 02138-4302 | 2012-09-06 |
| 1659685311 | Guy Wesley Skelton | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139 | 2010-08-04 |
| 1740509959 | Linda Gillespie | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2010-05-27 |
| 1326370164 | Marilyn Fisher | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2010-02-04 |
| 1265660021 | James Clifton Atkins II | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2009-06-30 |
| 1619158516 | Denise Marie Mccambly | Registered Nurse | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2007-11-19 |
| Find all providers in CAMBRIDGE | ||||
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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.