Healthcare Provider Details

I. General information

NPI: 1972108785
Provider Name (Legal Business Name): KAY MARIE WALTER APNP, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAY MARIE SCHARTNER RN

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2428 N GRANDVIEW BLVD STE 102
WAUKESHA WI
53188-6906
US

IV. Provider business mailing address

PO BOX 474
HARTLAND WI
53029-0474
US

V. Phone/Fax

Practice location:
  • Phone: 262-875-5070
  • Fax:
Mailing address:
  • Phone: 262-875-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10601-33
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number10601-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: