Doctor Name: | RACHELLE WALTON |
NPI Number: | 1164847083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ARNP3363992 |
Business Practice Address: | 1000 E Tarpon Ave Tarpon Springs, FL - 346895438 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 510 Haverhill Ln, SAFETY HARBOR |
State: | FL |
Postal Code: | 346954435 |
Phone Number: | 7277819050 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2014 |
NPI Last Update Date: | 02/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP3363992 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |