Individual
CHRISTA JO WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4501 S BOUNDARY PIKE, PORTLAND, IN 47371-8940
(765) 748-5226
Mailing address
4501 S BOUNDARY PIKE, PORTLAND, IN 47371-8940
(765) 748-5226
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003894A
IN
Other
Enumeration date
10/19/2011
Last updated
11/14/2023
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