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Crystal Nichole Wallace, NP-C
Nurse Practitioner in Hattiesburg, Mississippi
NPI 1629550496

Crystal Nichole Wallace is a Nurse Practitioner based in Hattiesburg, MS. Crystal Nichole Wallace practices in Hattiesburg, MS and has the professional credentials of NP-C. The NPI Number for Crystal Nichole Wallace is 1629550496 and holds a License No. 902669 (Mississippi).

The current practice location address for Crystal Nichole Wallace is 106 Asbury Cir, Hattiesburg, MS and can be reached out via phone at 601-268-8698.

Location: 106 Asbury Cir, Hattiesburg, MS, 39402-8114
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629550496
Provider Name
Crystal Nichole Wallace
Credential
NP-C
Provider Entity Type
Individual
Gender
Female
Address
106 Asbury Cir, Hattiesburg, MS, 39402-8114
Phone Number
601-268-8698
Fax Number
Provider Enumeration Date
08/29/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
106 Asbury Cir
City
Hattiesburg
State
Mississippi
Zip
39402-1302
Phone Number
601-268-8698
Fax Number
person
Provider Business Mailing Address Details
Address
106 Asbury Cir
City
Hattiesburg
State
Mississippi
Zip
39402-1302
Phone Number
601-268-8698
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
902669 (Mississippi)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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