MEDICARE: KATHY DIANE WALLS RN, BSN

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	163W00000X	Registered Nurse	436807	TX

General Provider Information

NPI Number	:	1619116746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY DIANE WALLS RN, BSN

Provider Business Mailing Address
First Line	:	1200 COUNTRY CLUB LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2353
Country	:	US
Telephone Number	:	817-451-1404
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 COUNTRY CLUB LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2353
Country	:	US
Telephone Number	:	817-451-1404
Fax Number	:

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

Provider Enumeration Date	:	02/12/2009
Last Update Date	:	02/12/2009

Similar Medicare Providers

1205833340 — WALLS UNIVERSAL HOME HEALTH & HOSPICE SERVICES, INC.
Practice Location Address:

1208 COUNTRY CLUB LN
FORT WORTH, TX
76112-2353

Practice Phone: 817-451-1404
Practice Fax: 817-451-5029

1801052469 — UNIVERSAL HEALTH REHAB SERVICES, INC
Practice Location Address:

1200 COUNTRY CLUB LN
FORT WORTH, TX
76112-2353

Practice Phone: 817-446-4340
Practice Fax:

1700165123 — UNIVERSAL STAFFING, INC.
Practice Location Address:

1208 COUNTRY CLUB LN
FORT WORTH, TX
76112-2353

Practice Phone: 817-451-1404
Practice Fax: 817-451-5029

1376224063 — MS. RACHEL MARIE HART RDN, LD
Practice Location Address:

3200 SANDAGE AVE
FORT WORTH, TX
76109-2353

Practice Phone: 614-315-7814
Practice Fax:

1487977526 — ALL HEALTH CARE SERVICES, INC.
Practice Location Address:

1123 N FEDERAL HWY
LAKE WORTH BEACH, FL
33460-2353

Practice Phone: 561-487-0553
Practice Fax: 561-487-0555

1134439730 — MR. THOMAS LIBERTO LMT
Practice Location Address:

1123 N FEDERAL HWY
LAKE WORTH, FL
33460-2353

Practice Phone: 561-582-2306
Practice Fax: 561-582-2307

Directions to “ KATHY DIANE WALLS RN, BSN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.