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General NPI Number Information
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NPI Number | 1558960674
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Entity Type | Individual
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Provider Name | ALICIA N WALLS APRN, FNP-C, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 110 S STANFIELD RD STE C
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City | TROY
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State | OH
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Zip | 45373-3689
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Country | US
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Telephone | 937-787-6859
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Fax | 937-500-5401
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Provider Business Mailing Address
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Address Line | 24 WAGNER RD
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City | WEST MILTON
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State | OH
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Zip | 45383-1612
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Country | US
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Telephone | 937-760-8960
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Fax | 937-500-5401
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0027836
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0027836
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0027836
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License Number State | OH
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