Individual
KRISTEN ELIZABETH WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
660 L ST NW STE 430, WASHINGTON, DC 20001-3615
(202) 677-3302
Mailing address
1410 N SCOTT ST APT 1065, ARLINGTON, VA 22209-2971
(214) 926-3261
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
0001294252
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024194511
VA
Other
Enumeration date
07/31/2025
Last updated
04/20/2026
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