MEDICARE: KARLA J WALDEN CNP

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
1	363LF0000X	Family Nurse Practitioner	COA 14395 NP	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.14395	OH

General Provider Information

NPI Number	:	1235472101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA J WALDEN CNP

Provider Business Mailing Address
First Line	:	508 MILLER ST
Second Line	:
City	:	LEBANON
State	:	OH
Zip	:	45036-1934
Country	:	US
Telephone Number	:	513-444-9916
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 EDEN PARK DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-6005
Country	:	US
Telephone Number	:	513-240-2625
Fax Number	:	858-216-1988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2013
Last Update Date	:	07/25/2024

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