Individual
MRS. KATHRYN A. WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
190 RT. 31, STE. 100, FLEMINGTON, NJ 08822
(908) 788-6654
(908) 788-6452
Mailing address
2100 WESCOTT DR., HBH, FLEMINGTON, NJ 08822
(908) 788-6654
(908) 788-6452
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00310900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311081
—
NJ
Enumeration date
02/03/2012
Last updated
08/05/2015
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