Catherine Wallace

Registered Dietitian · Jacksonville Beach, FL

Individual Active NPI

NPI number 1477244077

Practice location

1320 Roberts Dr
Jacksonville Beach, FL 32250-3253
Phone
(904) 477-9882

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NPI record

NPI
1477244077
Entity type
Individual (Type 1)
Enumeration date
May 16, 2023
Last updated
May 16, 2023
Certified
May 16, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Registered Dietitian Primary 133V00000X ND4727 FL

Mailing address

709 4TH Ave N
Jacksonville Beach, FL 32250-4527
Phone
(904) 477-9882

About Catherine Wallace

Catherine Wallace is a healthcare provider registered in the NPI registry with the primary taxonomy Registered Dietitian (code 133V00000X). The practice location is 1320 Roberts Dr, Jacksonville Beach, FL 32250-3253. The NPI number 1477244077 was assigned on May 16, 2023 and the record was last updated on May 16, 2023.

Catherine Wallace lists a license in the registry: #ND4727 (FL) for Registered Dietitian. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Catherine Wallace?

The NPI number is 1477244077.

What is the phone number of Catherine Wallace?

The phone number listed for the practice location is (904) 477-9882.

Where is Catherine Wallace located?

1320 Roberts Dr, Jacksonville Beach, FL 32250-3253.

What is the taxonomy code for Catherine Wallace?

The primary taxonomy code is 133V00000X – Registered Dietitian.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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