| Doctor Name: | LYNETTE A WALTER |
| NPI Number: | 1528052958 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA001452L |
| Business Practice Address: | 111 Nason Dr Roaring Spring, PA - 166731212 |
| Business Phone Number: | 8142245132 |
| Business Fax Number: | 8142242906 |
| Mailing Address: | 111 Nason Dr, ROARING SPRING |
| State: | PA |
| Postal Code: | 166731212 |
| Phone Number: | 8142245132 |
| Fax Number: | 8142242906 |
| NPI Enumeration Date: | 08/31/2005 |
| NPI Last Update Date: | 11/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA001452L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |