Individual
DENISE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
444 SAWYER DR, HARPERS FERRY, WV 25425-5885
(304) 676-8468
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
63349
WV
363LA2200X
Adult Health Nurse Practitioner
63349
WV
363LG0600X
Gerontology Nurse Practitioner
Primary
63349
WV
Other
Enumeration date
12/09/2015
Last updated
01/04/2017
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