Individual
KRISTI WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
74 E 18TH AVE, STE 5, EUGENE, OR 97401-4081
(541) 255-2248
(541) 735-3260
Mailing address
74 E 18TH AVE, STE 5, EUGENE, OR 97401-4081
(541) 343-3455
(541) 735-3260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201050185NP
OR
Other
Enumeration date
09/22/2010
Last updated
10/13/2016
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