Individual
VONDA FAYE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1710 W 12TH ST, LAUREL, MS 39440-2559
(601) 369-2021
Mailing address
1710 W 12TH ST, LAUREL, MS 39440-2559
(601) 369-2021
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R522384
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119538
—
MS
05
—
01224218
—
MS
Enumeration date
07/12/2006
Last updated
05/03/2026
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