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Individual

DR. ALVIN REED WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
155 GLASSON WAY, GRASS VALLEY, CA 95945-5723
(530) 274-6000
Mailing address
12358 ELIZABETH WAY, GRASS VALLEY, CA 95949-6517
(425) 478-7051

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95010726
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95010726
LICENSE/ FURNISHING NUMBER
CA
01
F01191203
AANP BOARD CERTIFICATION NUMBER
Enumeration date
02/01/2019
Last updated
02/01/2019
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