Healthcare Provider Details

I. General information

NPI: 1316879869
Provider Name (Legal Business Name): CHRISTINE KIM WALTER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6975 W GLENDALE AVE
GLENDALE AZ
85303-2611
US

IV. Provider business mailing address

7426 W TETHER TRL
PEORIA AZ
85383-7353
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax:
Mailing address:
  • Phone: 918-404-3569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number233876
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: