Individual
MRS. RENAE MICHELLE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1213 W MOREHEAD ST FL 5, CHARLOTTE, NC 28208-5576
(980) 780-2307
(980) 780-2308
Mailing address
1213 W MOREHEAD ST FL 5, CHARLOTTE, NC 28208-5576
(980) 780-2307
(980) 780-2308
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
5004002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2593282
MEDICARE INDIVIDUAL NUMBER
NC
Enumeration date
07/17/2007
Last updated
09/04/2025
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