MEDICARE: MRS. WENDY S. WALSH APRN, NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	102847	MA

General Provider Information

NPI Number	:	1033322581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WENDY S. WALSH APRN, NP-C

Provider Business Mailing Address
First Line	:	51 EDWIN ST
Second Line	:
City	:	RANDOLPH
State	:	MA
Zip	:	02368-1914
Country	:	US
Telephone Number	:	508-565-1307
Fax Number	:

Provider Business Practice Location Address
First Line	:	STONEHILL COLLEGE HEALTH SERVICES
Second Line	:	320 WASHINGTON ST.
City	:	NORTH EASTON
State	:	MA
Zip	:	02357-0001
Country	:	US
Telephone Number	:	508-565-1307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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