Individual
MS. NAN KILPATRICK WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 882-3007
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F333092-1
NY
363L00000X
Nurse Practitioner
Primary
TP006735B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02299943
—
NY
01
—
GU039818
PA MEDICARE GROUP
PA
Enumeration date
02/24/2006
Last updated
02/26/2021
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