Jalisa Waller, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

357089 Issued in NY

Practice address

43 Crest Hill Dr
Rochester, NY 14624-1403

Phone

(585) 759-8189

NPI assigned

Sep 23, 2026

Last updated

Sep 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1790698538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CREST HILL DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241403",
            "telephone_number": "585-759-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 CREST HILL DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146241403",
            "telephone_number": "585-759-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JALISA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "357089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Wallace, CRPA
• Kelleyayn Wallace, PA
• Lisa Michelle Wallace, DDS
• Maxwell Wallace, PSYD
• Meghan Elizabeth Wallace, LMSW
• Lisa Wallin, ANP-C, CWS
• Ian William Wallis, MD
• Brynn Elizabeth Waloven, MSW
• Nicole Marie Walrath, DO
• Sara Walrath, LMT

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.