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General NPI Number Information
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NPI Number | 1013205251
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Entity Type | Individual
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Provider Name | ANDREA WALTER PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 600 S 70TH ST
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City | LINCOLN
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State | NE
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Zip | 68510-2451
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Country | US
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Telephone | 402-489-3802
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Fax | 402-486-7860
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Provider Business Mailing Address
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Address Line | 4500 NW 54TH ST
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City | LINCOLN
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State | NE
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Zip | 68524-1025
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13656
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License Number State | NE
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