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

Jasmine Renee Wallace

Individual provider Contractor · NPI 1710324165

Jasmine Renee Wallace is a Contractor in Lawton, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

5535 NW Cache Rd APT:8G
Lawton, OK 73505-3336
Phone: (580) 713-9316
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 number1710324165
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 24, 2013
Last updated in NPPESMay 24, 2013
Mailing address5535 Nw Cache Rd, Apt:8g, Lawton, OK 73505-3336

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