Individual
MRS. DIANE CAROL WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN REGISTERED NURSE
Contact information
Practice address
1661 FALLS ROAD, GRAFTON, WI 53024
(262) 375-2972
Mailing address
1661 FALLS ROAD, GRAFTON, WI 53024
(262) 375-2972
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35035200
—
WI
Enumeration date
07/31/2007
Last updated
07/31/2007
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