Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Robert Wallace, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1003950288

Robert Wallace, CRNA is a Certified Registered Nurse Anesthetist in Jackson, Tennessee. Licensed in Tennessee. Registered with an NPI since 2007.

Licensed in
TN
In the registry since
2007
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

367 Hospital Blvd
Jackson, TN 38305-2080
Phone: (731) 661-2227
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 53447 (TN)

Record details

NPI number1003950288
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedFebruary 19, 2007
Last updated in NPPESNovember 4, 2011

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