Healthcare Provider Details

I. General information

NPI: 1598554578
Provider Name (Legal Business Name): BRITTNEY WALLER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGH ST STE B
WORTHINGTON OH
43085-4093
US

IV. Provider business mailing address

5925 PAINTED LEAF DR
NEW ALBANY OH
43054-8156
US

V. Phone/Fax

Practice location:
  • Phone: 614-810-8575
  • Fax: 614-807-2373
Mailing address:
  • Phone: 614-571-5729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0038755
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: