Healthcare Provider Details

I. General information

NPI: 1598390676
Provider Name (Legal Business Name): KIRSTEN IRENE WALTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIRSTEN IRENE BOONE MD

II. Dates (important events)

Enumeration Date: 03/09/2020
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 L ST NW STE 450
WASHINGTON DC
20037-1541
US

IV. Provider business mailing address

197 CANTERBERRY LN SW
REYNOLDSBURG OH
43068-3205
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD600003616
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: