Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John Wallace, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1265891295

John Wallace, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Las Cruces, New Mexico. Qualified in 2015, 11 years ago. Practices with Novus Colorado Professional Corporation, a 12-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Colorado, Illinois, Minnesota and New Mexico and 2 more.

Years since qualifying
11
Licensed in
CO, IL, MN, NM, WA, WI
In the registry since
2016
Specialties on file
6
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

4351 E Lohman Ave
Las Cruces, NM 88011-8259
Phone: (970) 216-5385
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 333 Smith Ave N, Saint Paul, MN 55102-2344 — (651) 241-4000
  • 2811 Tieton Dr, Yakima, WA 98902-3761 — (970) 216-5385

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence CRNA 01415 (NM)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence APN.0996269-CRNA (CO)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 209021371 (IL)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 2355 (MN)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 10406-33 (WI)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence AP61248892 (WA)

Record details

NPI number1265891295
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedFebruary 18, 2016
Last updated in NPPESMay 11, 2022
Certification dateMay 11, 2022
Mailing addressPo Box 436, Ouray, CO 81427-0436

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Novus Colorado Professional Corporation — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Las Cruces