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

Renna R Wallace

Individual provider Registered Nurse · NPI 1649975053

Renna R Wallace is a Registered Nurse in Perth Amboy, New Jersey. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2023
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Practice location Address checks out

5 Dally Ct
Perth Amboy, NJ 08861-2967
Phone: (718) 812-9691
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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 875482 (NY)

Record details

NPI number1649975053
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 4, 2023
Last updated in NPPESApril 4, 2023
Certification dateApril 4, 2023
Mailing address5 Dally Ct, Perth Amboy, NJ 08861-2967

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