Doctor Name: | MS. NANCY LYNN PESTA WALSH |
NPI Number: | 1093982837 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | R 126866-3 |
Business Practice Address: | 200 State Ave Faribault, MN - 550216339 |
Business Phone Number: | 5073346451 |
Business Fax Number: | |
Mailing Address: | 201 N Ridge Dr, KENYON |
State: | MN |
Postal Code: | 559461532 |
Phone Number: | 5077896883 |
Fax Number: | |
NPI Enumeration Date: | 05/12/2008 |
NPI Last Update Date: | 02/26/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R 126866-3 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |