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NPI Code Detail

MEDICARE: MRS. KATHERINE RACHEL WALL RN

MEDICARE: MRS. KATHERINE RACHEL WALL 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
1363LW0102XWomen's Health Nurse Practitioner9958MN
2163W00000XRegistered Nurse95058339CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427699628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHERINE RACHEL WALL RN
Provider Business Mailing Address
First Line : 1045 OAKWOOD RD
Second Line :
City : NEWPORT
State : MN
Zip : 55055-1838
Country : US
Telephone Number : 585-489-4304
Fax Number :
Provider Business Practice Location Address
First Line : 1200 LAGOON AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2077
Country : US
Telephone Number : 612-823-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2019
Last Update Date : 04/23/2026

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