Dr Jenna Rose Wallace, DNP, APRN, CNP - Medicare Nurse Practitioner in West Fargo, ND

Dr Jenna Rose Wallace, DNP, APRN, CNP is a medicare enrolled "Nurse Practitioner - Family" in West Fargo, North Dakota. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Sanford Medical Center Fargo and her current practice location is 1220 Sheyenne St, West Fargo, North Dakota. You can reach out to her office (for appointments etc.) via phone at (701) 234-4445.

Dr Jenna Rose Wallace is licensed to practice in North Dakota (license number R37792) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1093236572.

Contact Information

Dr Jenna Rose Wallace, DNP, APRN, CNP
1220 Sheyenne St,
West Fargo, ND 58078-2637
(701) 234-4445
(701) 234-4456



Provider's Profile

Full NameDr Jenna Rose Wallace
GenderFemale
SpecialityNurse Practitioner
Experience7 Years
Location1220 Sheyenne St, West Fargo, North Dakota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Jenna Rose Wallace graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1093236572
  • Provider Enumeration Date: 07/05/2017
  • Last Update Date: 07/05/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 2769755990
  • Enrollment ID: I20170908002532

Medical Identifiers

Medical identifiers for Dr Jenna Rose Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093236572NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family R37792 (North Dakota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Sanford Medical Center FargoFargo, NDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Sanford Medical Center Fargo84269678031094

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jenna Rose Wallace allows following entities to bill medicare on her behalf.
Entity NameSanford Clinic North
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942241351
PECOS PAC ID: 4284546151
Enrollment ID: O20031112000221

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Entity NameSanford Medical Center Fargo
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184917924
PECOS PAC ID: 8426967803
Enrollment ID: O20110331000495

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jenna Rose Wallace is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Jenna Rose Wallace, DNP, APRN, CNP
3122 46th Ave S,
Fargo, ND 58104-6658

Ph: (701) 520-1852
Dr Jenna Rose Wallace, DNP, APRN, CNP
1220 Sheyenne St,
West Fargo, ND 58078-2637

Ph: (701) 234-4445

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Nurse Practitioner Nurses in West Fargo, ND

James Troy Upton, APRN, CNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3306 Sheyenne St Ste 216, West Fargo, ND 58078
Phone: 701-532-1731    Fax: 701-532-1940
Cynthia Nicole Vingelen, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1220 Sheyenne St, West Fargo, ND 58078
Phone: 701-234-4445    
Patricia K Slyter, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1401 13th Ave E, West Fargo, ND 58078
Phone: 701-364-0060    Fax: 701-364-0065
Cassie Marie Moores Kristensen,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1417 12th Street Ct, West Fargo, ND 58078
Phone: 415-278-1574    
Molly Christine Mcmanus,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1401 13th Avenue East, West Fargo, ND 58078
Phone: 701-364-5722    
Marjorie Masten, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1401 13th Ave E, West Fargo, ND 58078
Phone: 701-364-5751    

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