Individual
KELLY NICOLE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
210 N UNION ST, BETHEL, OH 45106-1124
(513) 734-9050
(513) 734-9051
Mailing address
5400 DUPONT CIR, SUITE A, MILFORD, OH 45150-2793
(513) 576-7700
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN281265 NP06528
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2561624
—
OH
05
—
2565399
—
OH
Enumeration date
01/20/2006
Last updated
07/12/2021
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