Individual
STEPHANIE LEEANN WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
720 ESKENAZI AVE, FIFTH THIRD BANK BLDG, 5TH FL, INDIANAPOLIS, IN 46202-5166
(317) 880-4121
(317) 880-0343
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28209559A
IN
363L00000X
Nurse Practitioner
Primary
71009394A
IN
363LG0600X
Gerontology Nurse Practitioner
71009394A
IN
Other
Enumeration date
08/09/2019
Last updated
11/11/2025
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