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Individual

MRS. DEBRA KAY WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NPC

Contact information

Practice address
2709 N TEJON ST, COLORADO SPRINGS, CO 80907-6231
(719) 473-0872
(719) 630-3658
Mailing address
2709 N TEJON ST, COLORADO SPRINGS, CO 80907-6231
(719) 473-0872
(719) 630-3658

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
82294
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
82294
COLORADO LICENSE
CO
01
C99908
MEDICARE ID TYPE
CO
Enumeration date
09/09/2005
Last updated
10/23/2007
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