Individual
NICOLE MAUREEN WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MPA, IBCLC
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-2641
Mailing address
18160 COTTONWOOD RD, 368, BEND, OR 97707-9317
(503) 716-2161
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
200141652RN
OR
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
200141652RN
OR
Other
Enumeration date
04/25/2008
Last updated
01/22/2016
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