Individual provider · Type 1 NPI

Cristy L. Wallace, FNP

Nurse Practitioner · Fort Worth, TX

NPI number 1588959522 Active

Practice location

1651 W Rosedale St Ste 205
Fort Worth, TX 76104-7437

Call (817) 332-9966 Map

Fax (817) 332-9977

Mailing address

PO Box 961205
Fort Worth, TX 76161-0205

Specialties and licenses

TaxonomyCodeLicense
Nutrition Chiropractor 111NN1001X7203 (TX)
Nutritionist 133N00000XNone listed
Nurse Practitioner Primary 363L00000XAP120370 (TX)

Nurse Practitioner: (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 wit…

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About NPI 1588959522

Cristy L. Wallace, FNP's National Provider Identifier is 1588959522, issued on Jun 17, 2011. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Worth, TX. The record was last updated on Aug 13, 2014.