Individual
DONALD VINCENT WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
2501 N STOCKTON HILL RD STE 108, KINGMAN, AZ 86401-4140
(928) 255-5050
Mailing address
534 ENCHANTED LAKES DR, HENDERSON, NV 89052-5626
(702) 513-9070
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
313585
AZ
Other
Enumeration date
10/11/2024
Last updated
02/19/2025
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