Doctor Name: | DENISE WALTER |
NPI Number: | 1306211883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | AGACNP-BC |
License Number: | 63349 |
Business Practice Address: | Mulberry Tree Stree Charles Town, WV - 25414 |
Business Phone Number: | 3047241101 |
Business Fax Number: | |
Mailing Address: | 444 Sawyer Dr, HARPERS FERRY |
State: | WV |
Postal Code: | 254255885 |
Phone Number: | 3046768468 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2015 |
NPI Last Update Date: | 12/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 63349 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |