Individual
BETTY L WALLEN
Active
Individual
BETTY L WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP386202
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3079040-00
—
FL
01
—
430066582
RAILROAD MEDICARE
FL
01
—
G0237
BCBS OF FLORIDA
FL
Enumeration date
08/12/2006
Last updated
04/23/2008
Update your record
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