| Doctor Name: | MRS. KATHRYN A. WALL |
| NPI Number: | 1083986251 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 26NJ00310900 |
| Business Practice Address: | 190 Rt. 31 Ste. 100 Flemington, NJ - 08822 |
| Business Phone Number: | 9087886654 |
| Business Fax Number: | 9087886452 |
| Mailing Address: | 2100 Wescott Dr., Hbh FLEMINGTON |
| State: | NJ |
| Postal Code: | 08822 |
| Phone Number: | 9087886654 |
| Fax Number: | 9087886452 |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 08/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 26NJ00310900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |