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

Jelisa Wallace, CRNP

Individual provider Family Nurse Practitioner · NPI 1649889478

Jelisa Wallace, CRNP is a Family Nurse Practitioner in Huntsville, Alabama. Licensed in Alabama. Registered with an NPI since 2020.

Licensed in
AL
In the registry since
2020
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone: (256) 265-1000
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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 F06200386 (AL)

Record details

NPI number1649889478
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJuly 28, 2020
Last updated in NPPESMarch 12, 2024
Certification dateMarch 12, 2024

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