Doctor Name: | MARTHA LOUZELLE WALLS |
NPI Number: | 1770835043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | RN180573 |
Business Practice Address: | 1596 Highway 33 S New Tazewell, TN - 378257104 |
Business Phone Number: | 4236268271 |
Business Fax Number: | 4236260688 |
Mailing Address: | 6350 W Andrew Johnson Hwy, Department 100 TALBOTT |
State: | TN |
Postal Code: | 378778605 |
Phone Number: | 8003553565 |
Fax Number: | 4237142355 |
NPI Enumeration Date: | 10/10/2012 |
NPI Last Update Date: | 10/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | RN180573 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |