| Doctor Name: | MRS. KIM EVELYN HALAQUIST |
| NPI Number: | 1043522170 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | F336402 |
| Business Practice Address: | 6 Franklin Rd Walton, NY - 138561214 |
| Business Phone Number: | 6078655800 |
| Business Fax Number: | 6078655882 |
| Mailing Address: | Po Box 237, WALTON |
| State: | NY |
| Postal Code: | 138560237 |
| Phone Number: | 6078655800 |
| Fax Number: | 6078655882 |
| NPI Enumeration Date: | 07/06/2010 |
| NPI Last Update Date: | 07/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | F336402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |