MEDICARE: MATTHEW JOSEPH WALNY 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
1	367500000X	Certified Registered Nurse Anesthetist	APRN.CRNA.0021574	OH

General Provider Information

NPI Number	:	1669153102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW JOSEPH WALNY RN

Provider Business Mailing Address
First Line	:	2142 N COVE BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3895
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2142 N COVE BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-3895
Country	:	US
Telephone Number	:	419-291-4491
Fax Number	:	419-479-6030

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

Provider Enumeration Date	:	07/27/2023
Last Update Date	:	06/04/2026

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