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NPI Code Detail

MEDICARE: MRS. SUSAN GAIL WALTON ARNP

MEDICARE: MRS. SUSAN GAIL WALTON ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN2567282FL

General Provider Information

NPI Number : 1073759197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN GAIL WALTON ARNP
Provider Business Mailing Address
First Line : 877 MADERIA CIR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32312-1833
Country : US
Telephone Number : 850-294-5650
Fax Number :
Provider Business Practice Location Address
First Line : 648 FLORIDA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-6311
Country : US
Telephone Number : 850-769-6001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2008
Last Update Date : 12/18/2008

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Directions to “ MRS. SUSAN GAIL WALTON ARNP” Practice Location

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