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

Jahqwale Wallace

Individual provider Contractor · NPI 1053822999

Jahqwale Wallace is a Contractor in Valdosta, Georgia. Practices as a sole proprietor. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

1501 Myrtle St Apt C3
Valdosta, GA 31601-3071
Phone: (912) 704-9805
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X

Record details

NPI number1053822999
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 18, 2017
Last updated in NPPESOctober 18, 2017

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