Individual
MS. KATINA WALLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-8000
Mailing address
304 LARKTREE LN, FUQUAY VARINA, NC 27526-7652
(773) 320-0778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
186430
NC
363AM0700X
Medical Physician Assistant
085-002067
IL
Other
Enumeration date
11/22/2006
Last updated
05/01/2013
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