Jenny Wallace

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R215037 Issued in MD

Practice address

121 Old Solomons Island Rd
Annapolis, MD 21401-4367

Phone

(410) 224-3663

NPI assigned

Mar 11, 2026

Last updated

Mar 11, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chesapeake Pediatrics LLC

  • Pediatrics Physician
  • Annapolis, MD
  • NPI 1396934816
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1164379186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014367",
            "telephone_number": "410-224-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214014367",
            "telephone_number": "410-224-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-03-11",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R215037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Walker, LGPC
• Yessica Fernanda Walker, LMSW
• Jennifer Rae Wall, DC
• Asher Wallace
• Gladys Wallace
• Scott Andrew Wallace, M.D.
• Marissa I Wallie, D.C.
• John Douglass Wallop
• John Douglass Wallop II, DPT
• Leslie Ann Wallop, P.T.

• Family Nurse Practitioner in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.