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NPI Code Detail

MEDICARE: MRS. KRISTEN ANN WALLS RN

MEDICARE: MRS. KRISTEN ANN WALLS RN
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
1163W00000XRegistered Nurse329871OH

General Provider Information

NPI Number : 1386791036
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTEN ANN WALLS RN
Provider Business Mailing Address
First Line : 16 W CHARLOTTE AVE
Second Line : 1
City : CINCINNATI
State : OH
Zip : 45215-2013
Country : US
Telephone Number : 513-761-3564
Fax Number :
Provider Business Practice Location Address
First Line : 16 W CHARLOTTE AVE
Second Line : 1
City : CINCINNATI
State : OH
Zip : 45215-2013
Country : US
Telephone Number : 513-761-3564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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