KRISTEN WALLACE (NPI# 1679019350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679019350 |
| Entity Type | Individual |
| Full Name | KRISTEN WALLACE |
| Credential | FNP-C |
| Practice Address |
2470 Flowood Dr Flowood MS 39232-9019 |
| Practice Telephone | 6016641213 |
| Practice Fax Number | 6019328869 |
| Mailing Telephone | 6016641213 |
| Mailing Fax Number | 6019328869 |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
901914 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083274864 | Kristen Marie Wallace | Physical Therapist | 526 Central Ave, Dunkirk, NY 14048-2515 | 2019-06-14 |
| 1679761837 | Kristen Wallace | Specialist | 8653 W 84th Cir, Arvada, CO 80005-2315 | 2007-10-11 |
| 1538297544 | Kristen Wallace | Occupational Therapist | 5959 Corson Ave S, Seattle, WA 98108-2605 | 2007-03-01 |
| 1972039741 | Kristen Ashley Wallace | Student in an Organized Health Care Education/Training Program | 100 Woods Rd, Valhalla, NY 10595-1530 | 2017-05-11 |
| 1104263896 | Kristen Shae Wallace | Social Worker | 135 W 50th St, 6th Floor, New York, NY 10020-1201 | 2013-06-04 |
| 1629227715 | Kristen Wallace | Case Manager/Care Coordinator | 211 N 23rd St, Paragould, AR 72450-3949 | 2008-09-12 |
| 1659594729 | Kristen Wallace | Speech-Language Pathologist | 61 Corporate Cir, New Castle, DE 19720-2439 | 2007-04-10 |
| Street Address |
2470 FLOWOOD DR |
| City | FLOWOOD |
| State | MS |
| Zip Code | 39232-9019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881635225 | Lance Klein | Nurse Practitioner | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2006-06-09 |
| 1811514599 | Steven Cialone | Physical Therapist | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2020-06-29 |
| 1083252753 | Danielle Phillips | Orthopaedic Surgery | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2019-12-12 |
| 1437717824 | Elizabeth Anne Oliver | Physical Therapy Assistant | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2019-05-31 |
| 1891290243 | Ochsner Mississippi, LLC | Internal Medicine | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2018-03-28 |
| 1427407329 | Ochsner Clinic LLC | General Practice | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2016-06-10 |
| 1578911525 | Elliott Pettus | Physical Therapy Assistant | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2016-06-01 |
| 1659772556 | Amanda Cocilova | Nurse Practitioner | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2014-09-10 |
| 1821418872 | Mary Robinson | Physical Therapist | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2014-04-17 |
| 1538597554 | Newsouth Neurospine LLC | Pharmacy | 2470 Flowood Dr, Flowood, MS 39232-9019 | 2013-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164071775 | Leanna Nicole Howard | Social Worker | 2945 Layfair Drive, Apt. 1621, Flowood, MS 39232 | 2019-09-06 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1285101816 | Magnolia Anesthesia Consultants LLC | Anesthesiology | 4209 Lakeland Dr #252, Flowood, MS 39232 | 2018-11-01 |
| 1528543592 | Matthew T Armstrong | Physical Therapist | 104 Burney Drive, Flowood, MS 39232 | 2018-09-26 |
| 1790265627 | Mississippi Brain and Spine, Pllc | Non-Pharmacy Dispensing Site | 1 Layfair Drive, Ste 120, Flowood, MS 39232 | 2018-08-20 |
| 1629574918 | Billy Clifton Osbon Jr. | Pharmacist | 2506 Lakeland Drive, Suite 201, Flowood, MS 39232 | 2018-04-04 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1508398983 | Charles Pearson | Student in an Organized Health Care Education/Training Program | 764 Flowood Dr, Flowood, MS 39232 | 2017-04-03 |
| 1396288197 | Mary Claire Ponder | Nurse Practitioner | 151 E Metro Dr Ste 103, Flowood, MS 39232 | 2016-11-28 |
| Find all providers in zip 39232 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265924807 | Christina Perkins | Nurse Practitioner | 1006 Treetops Blvd Ste 101, Flowood, MS 39232-7645 | 2018-05-30 |
| 1457854408 | Leticia Fay Stribling | Nurse Practitioner | 2605 Courthouse Cir, Flowood, MS 39232-9521 | 2018-03-15 |
| 1316479124 | Christine Newman | Nurse Practitioner | 204 Woodgreen Cv, Flowood, MS 39232-7510 | 2017-03-30 |
| 1396288197 | Mary Claire Ponder | Nurse Practitioner | 151 E Metro Dr Ste 103, Flowood, MS 39232 | 2016-11-28 |
| 1326437740 | Jeremy David Hudson | Nurse Practitioner | 1710 Old Fannin Rd, Flowood, MS 39232-9004 | 2015-01-22 |
| 1144668146 | Kimberly Elizabeth Strong | Nurse Practitioner | 252 Katherine Dr, Ste A, Flowood, MS 39232-9024 | 2013-06-12 |
| 1538497334 | Melissa Harrell Mckissack | Nurse Practitioner | 4213 Lakeland Dr, Flowood, MS 39232-9212 | 2009-12-07 |
| 1205870706 | Cynthia Johnson Dean | Nurse Practitioner | 1080 River Oaks Dr Ste B103, Flowood, MS 39232-7602 | 2006-06-15 |
| 1013514553 | Jordan Claire Smith | Nurse Practitioner | 2550 Flowood Dr Ste 300, Flowood, MS 39232-9306 | 2020-10-07 |
| 1922615293 | Maria Katherine Townsend | Nurse Practitioner | 2506 Lakeland Dr Ste 300, Flowood, MS 39232-7640 | 2020-09-30 |
| Find all providers in FLOWOOD | ||||
Please comment or provide details below to improve the information on KRISTEN WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.