CRYSTAL NICHOLE WALLACE

HATTIESBURG, MS
NPI1629550496
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MS  902669)
Enumeration Date2018-08-29
Last Update Date2025-06-02
Business Address
CRYSTAL NICHOLE WALLACE NP-C
7148 U S HIGHWAY 98 STE 102
HATTIESBURG, MS 39402-9133
Phone number: 601-475-8270
Mailing Address
CRYSTAL NICHOLE WALLACE NP-C
3 CARRINGTON CT
HATTIESBURG, MS 39402-8114
Phone number: 601-810-8996
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