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

Mrs. Kristal Leann Wallace, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1801752449

Mrs. Kristal Leann Wallace, FNP-BC is a Nurse Practitioner in Edgewood, New Mexico. Qualified in 2025, 1 year ago. Practices with McLeod Medical Centers of Nm Inc, a 54-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
1
Licensed in
NM
In the registry since
2025
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1851 Old US 66
Edgewood, NM 87015-7200
Phone: (505) 286-2396
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 87084 (NM)

Record details

NPI number1801752449
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedDecember 29, 2025
Last updated in NPPESMay 6, 2026
Certification dateMay 6, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice McLeod Medical Centers Of Nm Inc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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