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NPI Profile for Dr CESALIE D WALLACE in JACKSONVILLE, AR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1407104052 |
|
| Status | Active | |
| Credentials | APN | |
| Entity | Individual | |
| Enumeration date | 08/29/2012 | |
| Last updated | 01/23/2026 - About 4 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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CESALIE D WALLACE
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CESALIE D WALLACE, APN