Mrs. Ciji Deyuana Wallace, RN-FNP
Mrs. Ciji Deyuana Wallace, RN-FNP is a Nurse Practitioner in Bogalusa, Louisiana. Qualified in 2024, 2 years ago. Practices with Memorial Hospital at Gulfport, a 470-clinician group and accepts Medicare assignment. Licensed in Louisiana and Mississippi.
- Years since qualifying
- 2
- Licensed in
- LA, MS
- In the registry since
- 2025
- Specialties on file
- 3
Practice location Address checks out
219 S Border DrBogalusa, LA 70427-3671
Phone: (985) 633-1952
Fax: (985) 732-4458
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Nurse Practitioner (primary) | Taxonomy 363LF0000X · Licence 240977 (LA) |
|---|---|
| Family Nurse Practitioner | Taxonomy 363LF0000X · Licence 907340 (MS) |
| Registered Nurse | Taxonomy 163W00000X · Licence 913403 (MS) |
Record details
| NPI number | 1487455036 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | RN-FNP |
| Sole proprietor | No |
| NPI enumerated | March 20, 2025 |
| Last updated in NPPES | October 14, 2025 |
| Certification date | October 14, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Group practice | Memorial Hospital At Gulfport — 470 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |
Practises at
- Memorial Hospital At Gulfport Hospital · Gulfport, MS
Colleagues at Memorial Hospital at Gulfport
- Bassam Baroudi, MD Cardiovascular Disease Physician · Gulfport, MS
- Dr. Jason L. Black, MD Emergency Medicine Physician · Ocean Springs, MS
- Andrew Borho, PA-C Physician Assistant · Biloxi, MS
- Alicia Lee Ellsberry, FNP Nurse Practitioner · Gulfport, MS
- Mrs. Jennifer Ann Ladner, MS, CFY/SLP Speech-Language Pathologist · Gulfport, MS
- Dr. David Larosa Jr., MD Internal Medicine Physician · Gulfport, MS
- Kelly Michelle Nations, MD Emergency Medicine Physician · Gulfport, MS
- Candace Noel Pendowski, ACNP Nurse Practitioner · Pascagoula, MS
- George Michael Shahin, MD Hematology & Oncology Physician · Biloxi, MS
- Dr. David Provosty Taylor Jr., MD Obstetrics & Gynecology Physician · Gulfport, MS
- Ashley Witter Nurse Practitioner · Ocean Springs, MS
- Erica Simmons Yang, WHNP Registered Nurse · Charleston, SC
Other providers in Bogalusa
-
Mrs. Noelle Marie Bordelon Plaisance, FNP-BC
433 Plaza St, Bogalusa, LA 70427-3729 · (985) 730-6700
-
Mr. James Anthony Seal, FNP
617 Avenue F, Bogalusa, LA 70427-3637 · (985) 730-6970
-
Amy Kennedy Seale, NP
617 Avenue F, Bogalusa, LA 70427-3637 · (985) 730-6970
-
Alison Leigh Thornhill, NP
2807 S Columbia St, Bogalusa, LA 70427-7915 · (985) 730-7310
-
Mr. Alvin Gene Williams, FNP
2781 S Columbia St, Bogalusa, LA 70427-7962 · (985) 241-5525