MEDICARE: AMY ANN WALCHENBACH ARNP, CFNP

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	AP61209858	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AP61209858	OTHER	WA	WA LICENSE

General Provider Information

NPI Number	:	1093705865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ANN WALCHENBACH ARNP, CFNP

Provider Business Mailing Address
First Line	:	275 SE CABOT DR STE B101
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3740
Country	:	US
Telephone Number	:	360-675-6648
Fax Number	:	360-679-9310

Provider Business Practice Location Address
First Line	:	275 SE CABOT DR STE B101
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3740
Country	:	US
Telephone Number	:	360-675-6648
Fax Number	:	360-679-9310

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	01/20/2022

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