| Ms Jessica Dene Wallace, CNM | |
|
167 North Main Street, Tuba City, AZ 86045-0600 | |
| (928) 283-2501 | |
| (928) 283-2677 |
| Full Name | Ms Jessica Dene Wallace |
|---|---|
| Gender | Female |
| Speciality | Certified Nurse Midwife (cnm) |
| Experience | 4 Years |
| Location | 167 North Main Street, Tuba City, Arizona |
| 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 |
|---|---|---|---|
| 1760100028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | CNM278747 (Arizona) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Tuba City Regional Health Care Corporation | 4284542531 | 151 |
| Entity Name | Tuba City Regional Health Care Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jessica Dene Wallace, CNM Po Box 600, Tuba City, AZ 86045-0600 Ph: (928) 283-2781 | Ms Jessica Dene Wallace, CNM 167 North Main Street, Tuba City, AZ 86045-0600 Ph: (928) 283-2501 |
Nikki Skrinak, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677 | |
Nancy S Whitson, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 167 North Main Street, Tuba City, AZ 86045 Phone: 928-283-2501 Fax: 928-283-2677 | |
Heidi Young-blackgoat, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 167 Main St, Tuba City, AZ 86045 Phone: 866-976-5941 | |
Linda Higgins, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 167 N Main Street, Tuba City, AZ 86045 Phone: 928-283-2441 |