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

Jessica Wallace

Individual provider Licensed Practical Nurse · NPI 1184820565

Jessica Wallace is a Licensed Practical Nurse in Boulder, Colorado. Licensed in Colorado. Registered with an NPI since 2007.

Licensed in
CO
In the registry since
2007
Specialties on file
2

Practice location Address checks out

580 Mohawk Dr
Boulder, CO 80303-3712
Phone: (303) 554-5185
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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 185784 (CO)
Licensed Practical Nurse Taxonomy 164W00000X · Licence 41618 (CO)

Record details

NPI number1184820565
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 22, 2007
Last updated in NPPESMay 2, 2008
Mailing address580 Mohawk Dr, Boulder, CO 80303-3712

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