Individual
DONNA W WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 783-4235
(704) 783-2527
Mailing address
18240 PAGES END, DAVIDSON, NC 28036-8001
(704) 892-4061
(704) 892-4295
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
076344
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050871
—
NC
Enumeration date
07/19/2006
Last updated
07/08/2007
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