Mrs Kristal Leann Wallace, FNP-BC - Nurse Practitioner in Edgewood, NM

Mrs Kristal Leann Wallace, FNP-BC is a Nurse Practitioner - Family based in Edgewood, New Mexico. Mrs Kristal Leann Wallace is licensed to practice in New Mexico (license number 87084) and her current practice location is 1851 Old Us 66, Edgewood, New Mexico. She can be reached at her office (for appointments etc.) via phone at (505) 286-2396.

NPI number for Mrs Kristal Leann Wallace is 1801752449 and her current mailing address is 1839 Black Gold St Se, Albuquerque, New Mexico. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1801752449.

Contact Information

Mrs Kristal Leann Wallace, FNP-BC
1851 Old Us 66,
Edgewood, NM 87015-7200
(505) 286-2396
Not Available

Map and Direction




Provider's Profile

Full NameMrs Kristal Leann Wallace
GenderFemale
SpecialityNurse Practitioner - Family
Location1851 Old Us 66, Edgewood, New Mexico
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1801752449
  • Provider Enumeration Date: 12/29/2025
  • Last Update Date: 12/29/2025

Medical Identifiers

Medical identifiers for Mrs Kristal Leann Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1801752449NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 87084 (New Mexico)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kristal Leann Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Kristal Leann Wallace, FNP-BC
1839 Black Gold St Se,
Albuquerque, NM 87123-2190

Ph: (602) 373-4929
Mrs Kristal Leann Wallace, FNP-BC
1851 Old Us 66,
Edgewood, NM 87015-7200

Ph: (505) 286-2396

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.