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General NPI Number Information
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NPI Number | 1922481712
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Entity Type | Individual
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Provider Name | SEAN PATRICK WALSH FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 2030 NORTH CHURCH PL
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City | SPARTANBURG
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State | SC
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Zip | 29303-2799
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Country | US
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Telephone | 864-234-1282
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 NORTH CHURCH PLACE
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City | SPARTANBURG
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State | SC
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Zip | 29303-2799
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Country | US
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Telephone | 864-433-0214
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19563
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License Number State | SC
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