Crystal Nichole Wallace is a Petal, Mississippi based nurse practitioner with 7 years of experience in . She completed her graduation in 2018. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Crystal Nichole Wallace is 902669 in Mississippi. Her current practice location is 50 Parkway Ln Ste B, Petal. Patients can reach her at 601-705-2897. Crystal Nichole Wallace is NP-C and her NPI number (Unique professional ID assigned by NPPES) is 1629550496. Crystal Nichole Wallace has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Crystal Nichole Wallace speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
1759625460
Enrollment ID:
I20181206003458
NPI Number:
1629550496
NPI Enumeration Date:
29 Aug, 2018
NPI Last Update On:
16 Apr, 2024
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Crystal Nichole Wallace are as mentioned below.
License Number
Specialization
State
Status
902669
Mississippi
Primary
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Crystal Nichole Wallace is associated with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Fast Pace Mississippi Pllc (3678832029)
121
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.