Healthcare Provider Details

I. General information

NPI: 1154791390
Provider Name (Legal Business Name): WALTON CALLEN WALLS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1747 OGLETREE RD STE B
AUBURN AL
36830-6648
US

IV. Provider business mailing address

1747 OGLETREE RD STE B
AUBURN AL
36830-6648
US

V. Phone/Fax

Practice location:
  • Phone: 334-787-9300
  • Fax: 334-787-9306
Mailing address:
  • Phone: 334-787-9300
  • Fax: 334-787-9306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-136572
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-136572
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: