National Provider Identifier
Jesse L Wallace, AG-ACNP
Jesse L Wallace, AG-ACNP is listed in the NPPES registry with a primary specialty of Acute Care Nurse Practitioner in Charlottesville, VA and a listed phone number of (434) 924-3627.
Source: public NPPES record, last updated December 06, 2024. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1013697267
- Provider Type
- Individual
- Primary Specialty
- Acute Care Nurse Practitioner
- Enumeration Date
- July 24, 2023
- Last Updated
- December 06, 2024
Practice Location
- 1215 Lee St
- Charlottesville, VA 22908-0816
Phone: (434) 924-3627
Mailing Address
- PO Box 749112
- Atlanta, GA 30374-9112
Specialties
- Acute Care Nurse Practitioner (363LA2100X)
- Critical Care Medicine (Anesthesiology) Physician (207LC0200X)
Endpoints
- jefferson.edu
Connect Url | Direct | Other | Philadelphia, PA 19123
Jefferson Health
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Biography
Jesse Wallace, AG-ACNP, is an adult-gerontology acute care nurse practitioner based in Charlottesville, with a practice location on UVA Health’s main medical center campus. His credentialing and location point to acute-care practice in an academic health-system setting.
Full Record
- NPI
- 1013697267
- Entity Type
- Individual
- Last Name
- Wallace
- First Name
- Jesse
- Middle Name
- L
- Credential
- AG-ACNP
- Mailing Street Address
- PO Box 749112
- Mailing City
- Atlanta
- Mailing State
- GA
- Mailing ZIP Code
- 30374-9112
- Mailing Country
- US
- Practice Street Address
- 1215 Lee St
- Practice City
- Charlottesville
- Practice State
- VA
- Practice ZIP Code
- 22908-0816
- Practice Country
- US
- Practice Phone
- (434) 924-3627
- Enumeration Date
- July 24, 2023
- Last Updated
- December 06, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 06, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Acute Care Nurse Practitioner (363LA2100X), Critical Care Medicine (Anesthesiology) Physician (207LC0200X)
- Other Identifiers
- NONE (None)