Jennifer Laird Wallace, is a
Licensed Practical Nurse based in Livingston, Texas. Jennifer Laird Wallace is licensed to practice in Texas (license number 330403) and her current practice location is
4468 Duff Rd, Livingston, Texas. She can be reached at her office (for appointments etc.) via phone at
(936) 215-1467.
NPI number for Jennifer Laird Wallace is 1497249882 and her current mailing address is 4468 Duff Rd, Livingston, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1497249882.
Healthcare Provider's Profile
| Full Name | Jennifer Laird Wallace |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 4468 Duff Rd, Livingston, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1497249882
- Provider Enumeration Date: 06/19/2018
- Last Update Date: 03/08/2026
Medical Identifiers
Medical identifiers for Jennifer Laird Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1497249882 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YP2500X | Counselor - Professional | 96257 (Texas) | Secondary |
| 164W00000X | Licensed Practical Nurse | 330403 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Laird Wallace is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jennifer Laird Wallace, 4468 Duff Rd, Livingston, TX 77351-5627 Ph: () - | Jennifer Laird Wallace, 4468 Duff Rd, Livingston, TX 77351-5627 Ph: (936) 215-1467 |
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