Jessica Wallace (NPI# 1316391055, PAC ID# 9739463761) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1316391055 |
| PAC ID by PECOS | 9739463761 |
| Professional Enrollment ID | I20170310001239 |
| Full Name | Jessica Wallace |
| Organization Legal Name | PAIN MANAGEMENT CENTER OF NORTH |
| Address |
2089 Southridge Dr Tupelo MS 38801-6478 |
| Phone Number | 6624070801 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 9638147408 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250004 | NORTH MISSISSIPPI MEDICAL CENTER |
| 250009 | MAGNOLIA REGIONAL HEALTH CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2089 Southridge Dr, Tupelo, MS 38801-6478 | 6624070801 | PAIN MANAGEMENT CENTER OF NORTH |
| Organization Legal Name | PAIN MANAGEMENT CENTER OF NORTH |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly Corbin Poland | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| George M Hammitt Iii | Interventional Pain Management | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Molly Hester-conway | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| William B Mckinley | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Holly J Kendrick | Nurse Practitioner | Pain Management Center of North | 200 Hwy 30 W, New Albany, MS 38652-3112 |
| Street Address |
2089 SOUTHRIDGE DR |
| City | TUPELO |
| State | MS |
| Zip | 38801-6478 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley W Jones | Certified Registered Nurse Anesthetist (crna) | Trident Anesthesia LLC | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Holly Corbin Poland | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| George M Hammitt Iii | Interventional Pain Management | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Molly Hester-conway | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Keven L Barber | Certified Registered Nurse Anesthetist (crna) | Trident Anesthesia LLC | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| William B Mckinley | Nurse Practitioner | Pain Management Center of North | 2089 Southridge Dr, Tupelo, MS 38801-6478 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas Porter Anderson | Physician Assistant | 1514 Cr, 41 Magnolia Manor At Tupelo, Tupelo, MS 38801 | |
| Sylvia Blanchard | Nurse Practitioner | 109 Parkgate, Tupelo, MS 38801 | |
| Lloyd Perry Britt Jr. | Optometry | 2270 W Main, Suite A, Tupelo, MS 38801-3144 | |
| Katie Elizabeth Richardson | Optometry | 2005 W Main St, Suite 102, Tupelo, MS 38801-3214 | |
| Rickey H Bullard | Podiatry | 1902 W Main St, Tupelo, MS 38801-3228 | |
| Chika Uchechukwu Iwueke | Psychiatry | 1601 W Main St, Suite D, Tupelo, MS 38801-3300 | |
| James Byron Shipp | Ophthalmology | 1413 W Main St, Tupelo, MS 38801-3400 | |
| Michelle M Hill | Qualified Speech Language Pathologist | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
| Janet H Smith | Physical Therapy | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
| Lee A Stewart | Physical Therapy | Ear, Nose and Throat Physicians of North Miss., P.a | 323 N Gloster St, Tupelo, MS 38801-3623 |
| Find all physicians in zip 38801 | |||
| City | TUPELO |
| Zip Code | 38801 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | TUPELO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Jessica Wallace.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.