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NPI Code Detail

MEDICARE: MRS. AUDREY MEANS WALTERS

MEDICARE: MRS. AUDREY MEANS WALTERS
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 PractitionerARNP9313478FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548671761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AUDREY MEANS WALTERS
Provider Business Mailing Address
First Line : 507 SW 17TH ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33315-1767
Country : US
Telephone Number : 954-788-0739
Fax Number :
Provider Business Practice Location Address
First Line : 1501 S FEDERAL HWY
Second Line :
City : POMPANO BEACH
State : FL
Zip : 33062-7512
Country : US
Telephone Number : 954-788-0739
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2014
Last Update Date : 04/29/2015

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Directions to “ MRS. AUDREY MEANS WALTERS ” Practice Location

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