Crystal Nichole Wallace is a Hattiesburg, 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 7148 U S Highway 98 Ste 102, Hattiesburg. Patients can reach her at 601-475-8270 or can fax her at 769-207-6209. 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.
Name:
Crystal Nichole Wallace
Specialization:
Nurse Practitioner (NP)
Gender:
Female
Credentials:
NP-C
Experience:
7+ years
Medical School Attended:
Other
Graduation Year:
2018
Accepts Medicare Assignment:
Yes
Practice Address:
7148 U S Highway 98 Ste 102, Hattiesburg, Mississippi, 39402-9133
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:
02 Jun, 2025
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.
Patients can reach Crystal Nichole Wallace at 7148 U S Highway 98 Ste 102, Hattiesburg, Mississippi or can call to book an appointment on 601-475-8270.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 June, 2025.