Individual
GAIL WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3820A BRIDGES STREET, MOREHEAD CITY, NC 28557
(252) 728-8550
Mailing address
225 STAR CHURCH RD, MARSHALLBERG, NC 28553
(252) 844-9022
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200022
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200222
NC FNP LICENSE NUMBER
NC
Enumeration date
04/10/2007
Last updated
07/08/2007
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