| Dr Cesalie Deonne Wallace, APN | |
|
3000 North First Street, Jacksonville, AR 72076 | |
| (501) 982-7477 | |
| Not Available |
| Full Name | Dr Cesalie Deonne Wallace |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 14 Years |
| Location | 3000 North First Street, Jacksonville, Arkansas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407104052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | A003758 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Uams Medical Center | Little rock, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Arkansas For Medical Sciences | 4082528955 | 1146 |
| Entity Name | University Of Arkansas For Medical Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588654016 PECOS PAC ID: 4082528955 Enrollment ID: O20031219000706 |
| Entity Name | St Vincent Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134176480 PECOS PAC ID: 5698758803 Enrollment ID: O20040622000224 |
| Entity Name | St. Vincent Physician Clinics Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134558398 PECOS PAC ID: 5395975379 Enrollment ID: O20140313001812 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Cesalie Deonne Wallace, APN 3000 North First Street, Jacksonville, AR 72076 Ph: (501) 982-7477 | Dr Cesalie Deonne Wallace, APN 3000 North First Street, Jacksonville, AR 72076 Ph: (501) 982-7477 |
Mrs. Candace Suzanne Ashley, MSN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2810 Northeastern Ave, Jacksonville, AR 72076 Phone: 501-992-7046 | |
Ashley Marie Randall, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 216 Chigger Valley Rd, Jacksonville, AR 72076 Phone: 501-650-2041 | |
Rita Margaret Odom, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1400 Braden St, Jacksonville, AR 72076 Phone: 800-893-9698 | |
Lorin Elizabeth Smith, MSN, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1400 Murrell Taylor Dr, Jacksonville, AR 72076 Phone: 501-255-2484 Fax: 501-642-0388 | |
Whitney Reed, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1110 W Main St, Jacksonville, AR 72076 Phone: 501-982-2108 Fax: 501-982-4951 | |
Ashley Renee Poppy, APRN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1401 Braden St, Jacksonville, AR 72076 Phone: 501-985-2537 | |
Sue Sullivan, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1409 Braden St, Jacksonville, AR 72076 Phone: 501-982-0576 Fax: 501-982-0041 |