MEDICARE: DEBRA WALTERS-OLARU APN

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	26NJ00017000	NJ

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

General Provider Information

NPI Number	:	1134213390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA WALTERS-OLARU APN

Provider Business Mailing Address
First Line	:	20 TAYLOR AVE
Second Line	:
City	:	MILMAY
State	:	NJ
Zip	:	08340-2016
Country	:	US
Telephone Number	:	856-466-2749
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 BOARDWALK
Second Line	:	SHOWBOAT WELLNESS CENTER
City	:	ATLANTIC CITY
State	:	NJ
Zip	:	08401-7509
Country	:	US
Telephone Number	:	609-343-4003
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/12/2013

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