Jailene Wallace, FNP-C - Nurse Practitioner in Providence, RI

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Jailene Wallace, FNP-C is a Nurse Practitioner - Family physician based in Providence, Rhode Island. Jailene Wallace is licensed to practice in Rhode Island (license number APRN04646) and her current practice location is 712 Broad St, Providence, Rhode Island. She can be reached at her office (for appointments etc.) via phone at (401) 233-5060.

NPI number for Jailene Wallace is 1891678702 and her current mailing address is Po Box 746088, Atlanta, Georgia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1891678702.

Contact Information

Jailene Wallace, FNP-C
712 Broad St,
Providence, RI 02907-1465
(401) 233-5060
Not Available

Map and Direction




Physician's Profile

Full NameJailene Wallace
GenderFemale
SpecialityNurse Practitioner - Family
Location712 Broad St, Providence, Rhode Island
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1891678702
  • Provider Enumeration Date: 07/29/2025
  • Last Update Date: 08/11/2025

Medical Identifiers

Medical identifiers for Jailene Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1891678702NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QG0300XFamily Medicine - Geriatric Medicine APRN04646 (Rhode Island)Secondary
363LF0000XNurse Practitioner - Family APRN04646 (Rhode Island)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. Jailene 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 AddressPractice Location Address
Jailene Wallace, FNP-C
Po Box 746088,
Atlanta, GA 30374-6088

Ph: () -		Jailene Wallace, FNP-C
712 Broad St,
Providence, RI 02907-1465

Ph: (401) 233-5060

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.