Individual
MR. ROBERT JOHN WALANTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2019 GALISTEO ST STE J1, SANTA FE, NM 87505-2103
(505) 820-0446
(505) 820-6142
Mailing address
2019 GALISTEO ST STE J1, SANTA FE, NM 87505-2103
(505) 820-0446
(505) 820-6142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
500800
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP00794
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13454234
—
NM
Enumeration date
07/12/2006
Last updated
10/21/2013
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