Doctor Name: | DEBRA WALTERS-OLARU |
NPI Number: | 1134213390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00017000 |
Business Practice Address: | 801 Boardwalk Showboat Wellness Center Atlantic City, NJ - 084017509 |
Business Phone Number: | 6093434003 |
Business Fax Number: | |
Mailing Address: | 20 Taylor Ave, MILMAY |
State: | NJ |
Postal Code: | 083402016 |
Phone Number: | 8564662749 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00017000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |