Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacque Wallis, RN

Individual provider Registered Nurse · NPI 1114546413

Jacque Wallis, RN is a Registered Nurse in Fort Collins, Colorado. Licensed in Colorado. Registered with an NPI since 2020.

Licensed in
CO
In the registry since
2020
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

1217 Riverside Ave
Fort Collins, CO 80524-3218
Phone: (970) 494-4200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 88881 (CO)

Record details

NPI number1114546413
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedApril 16, 2020
Last updated in NPPESApril 16, 2020
Certification dateApril 16, 2020
Mailing address4856 Innovation Dr Ste B, Fort Collins, CO 80525-5540

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