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

Individual provider Family Nurse Practitioner · NPI 1891678702

Jailene Wallace, FNP-C is a Nurse Practitioner in Providence, Rhode Island. Qualified in 2024, 2 years ago. Practices with Osh - Ri Physicians Group PC, a 32-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
2
Licensed in
RI
In the registry since
2025
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

712 Broad St
Providence, RI 02907-1465
Phone: (401) 233-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN04646 (RI)
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X · Licence APRN04646 (RI)

Record details

NPI number1891678702
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJuly 29, 2025
Last updated in NPPESSeptember 15, 2025
Certification dateSeptember 15, 2025
Mailing addressPo Box 746088, Atlanta, GA 30374-6088

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Osh - Ri Physicians Group Pc — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence