DR. CESALIE DEONNE WALLACE (NPI# 1407104052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407104052 |
| Entity Type | Individual |
| Full Name | DR. CESALIE DEONNE WALLACE |
| Credential | APN |
| Practice Address |
3000 North First Street Jacksonville AR 72076 |
| Practice Telephone | 5019827477 |
| Mailing Telephone | 5019827477 |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
A003758 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3000 NORTH FIRST STREET |
| City | JACKSONVILLE |
| State | AR |
| Zip Code | 72076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598396046 | Jennifer Michelle Price | Licensed Practical Nurse | 2400 West Main, Jacksonville, AR 72076 | 2020-02-03 |
| 1912464009 | Stat Home Health - Cenark LLC | Home Health | 1410 Braden Street, Jacksonville, AR 72076 | 2019-02-25 |
| 1649797671 | Caring Hearts Counseling, LLC | Case Management | 111 Marble Drive, Jacksonville, AR 72076 | 2017-08-30 |
| 1376071340 | Anne Elizabeth Houtchens | Speech-Language Pathologist | 2701 Tp White Drive, Jacksonville, AR 72076 | 2017-06-02 |
| 1881140648 | Jacksonville North Pulaski School District | Local Education Agency (LEA) | 1414 West Main, Jacksonville, AR 72076 | 2016-08-31 |
| 1134599772 | Jeremiah Melson Fleeman | Occupational Therapist | 2701 Tpwhite Drive, Jacksonville, AR 72076 | 2015-09-25 |
| 1821424565 | Kasey Michele Leeson | Social Worker | 2520 W. Main St., Jacksonville, AR 72076 | 2013-09-25 |
| 1952660995 | Joshua Aaron Hill | Case Manager/Care Coordinator | 2126 N. 1st St Suite F, Jacksonville, AR 72076 | 2012-05-11 |
| 1396023156 | Syreeta Tucker | Case Manager/Care Coordinator | 1109 Burman, Jacksonville, AR 72076 | 2011-07-28 |
| 1649577883 | Erica M Shackelford | Behavioral Analyst | 2126 N 1st. Street, Suite F, Jacksonville, AR 72076 | 2011-02-24 |
| Find all providers in zip 72076 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293868 | Maria Fe Guboc Rufano-sulit | Nurse Practitioner | 3682 Summerlin Ln, Jacksonville, FL 32224-1650 | 2020-10-21 |
| 1346849502 | Caitlin Flott | Nurse Practitioner | 14589 Camberwell Ln S, Jacksonville, FL 32258-1708 | 2020-10-20 |
| 1972101137 | Amanda Brooke Mills | Nurse Practitioner | 8459 Oak Crossing Dr W, Jacksonville, FL 32244-6949 | 2020-10-10 |
| 1649877200 | Shalom Barile | Nurse Practitioner | 1377 Ingleside Ave, Jacksonville, FL 32205-7733 | 2020-10-07 |
| 1013524248 | Claudia Joseph | Nurse Practitioner | 3331 Net Ct, Jacksonville, FL 32277-2735 | 2020-10-01 |
| 1063029577 | Erica Francisca Andrade | Nurse Practitioner | 5475 Turkey Creek Rd, Jacksonville, FL 32244-8549 | 2020-09-29 |
| 1568078418 | Jennifer Ruth Woodard | Nurse Practitioner | 29 Trinity Way, Jacksonville, AL 36265-5813 | 2020-09-16 |
| 1013522309 | William David Michal | Nurse Practitioner | 4417 Chippewa Dr, Jacksonville, FL 32210-6006 | 2020-09-13 |
| 1063025906 | Fabiola Baptiste | Nurse Practitioner | 9143 Philips Hwy Ste 110, Jacksonville, FL 32256-1365 | 2020-08-29 |
| 1295348464 | Debi Cohen | Nurse Practitioner | 11266 Cloverhill Ct, Jacksonville, FL 32257-1438 | 2020-08-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 72076 |
Please comment or provide details below to improve the information on DR. CESALIE DEONNE WALLACE.
| 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.