Individual
REBECCA WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
183 PEACE BLVD, SAINT JOSEPH, MI 49085-9146
(269) 428-3500
(269) 429-6429
Mailing address
183 PEACE BLVD, SAINT JOSEPH, MI 49085-9146
(269) 428-3500
(269) 429-6429
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704152349
MI
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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