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NPI Code Detail

MEDICARE: MRS. DEBORAH ANN WALSH FNP-BC

MEDICARE:  MRS. DEBORAH ANN WALSH  FNP-BC
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
1363LF0000XFamily Nurse Practitioner95003061CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NP95003061OTHERCALIC

General Provider Information

NPI Number : 1255574612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH ANN WALSH FNP-BC
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-906-4623
Fax Number :
Provider Business Practice Location Address
First Line : 701 S MAIN ST
Second Line :
City : NORFOLK
State : VA
Zip : 23523-1245
Country : US
Telephone Number : 757-388-1830
Fax Number : 855-939-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2009
Last Update Date : 09/26/2023

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Directions to “ MRS. DEBORAH ANN WALSH FNP-BC” Practice Location

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