Healthcare Provider Details

I. General information

NPI: 1609705078
Provider Name (Legal Business Name): HEATHER NICOLE WALTON APRN-CNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 COSHOCTON AVE
MOUNT VERNON OH
43050-1440
US

IV. Provider business mailing address

5929 NEWARK RD
MOUNT VERNON OH
43050-7500
US

V. Phone/Fax

Practice location:
  • Phone: 740-326-3521
  • Fax: 740-326-3522
Mailing address:
  • Phone: 740-258-9889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0042174
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: