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Individual
MR. ROSCOE CARL WALLS JR.
Active
Individual
MR. ROSCOE CARL WALLS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN253514
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003285774C
—
GA
Enumeration date
04/26/2023
Last updated
08/20/2026
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