Individual
KACI WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
220 S RIVER ST, PLAINS, PA 18705-1137
(570) 824-8151
Mailing address
49 ALLENBERRY DR, HANOVER TOWNSHIP, PA 18706-1481
(570) 328-5800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
XXXXXXX
PA
Other
Enumeration date
06/18/2017
Last updated
07/23/2024
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