Jennifer Wallace, PAC

Individual Active
NPI 1700864493
Medical Physician Assistant Saint Petersburg, FL

Jennifer Wallace, PAC holds NPI 1700864493, with a primary taxonomy of medical physician assistant and a practice location in Saint Petersburg, FL. The number was issued on January 4, 2006 and the NPPES record was last updated on October 8, 2015. The record lists 2 taxonomy codes.

This record hasn't been updated in NPPES since 2015. Details may be out of date.

Taxonomies and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X PA9105134 (FL)
Surgical Physician Assistant 363AS0400X PA9105134 (FL)

Practice location

625 6th Ave S
Suite 385
Saint Petersburg, FL 33701-4662
Phone: (727) 553-7100

Local context

Active NPPES records list 426 providers with medical physician assistant as the primary taxonomy within 25 miles of this practice location's ZIP code, 87 of them within 10 miles.

The same primary taxonomy is listed by 2,876 in Florida and 40,076 nationwide.

These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.

Record history

Name on record
Jennifer Lea Wallace
Status
Active
NPI issued
Last updated in NPPES

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NPPES data as of · Source: CMS NPPES

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