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

Quentin Wallace

Individual provider Case Manager/Care Coordinator · NPI 1558057372

Quentin Wallace is a Case Manager/Care Coordinator in Jackson, Mississippi. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

4780 I 55 Frontage Rd N Ste 105
Jackson, MS 39211-5542
Phone: (601) 956-4816
Fax: (601) 956-4817
Show map & directions

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

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1558057372
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 14, 2023
Last updated in NPPESApril 14, 2023
Certification dateApril 14, 2023
Mailing address4780 I 55 Frontage Rd N Ste 105, Jackson, MS 39211-5542

Other providers in Jackson