Individual
ANGELA WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
760 HOLTON WHITEHALL RD, WHITEHALL, MI 49461-9559
(231) 206-0703
Mailing address
760 HOLTON WHITEHALL RD, WHITEHALL, MI 49461-9559
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
145635
AK
363LF0000X
Family Nurse Practitioner
4704225835
MI
Other
Enumeration date
05/16/2013
Last updated
05/08/2020
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