Individual
CHRISTA D WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
311 W HIGH ST, LEBANON, KY 40033-1427
(270) 692-2774
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013503
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14627550
CAQH
—
05
—
7100660330
—
KY
Enumeration date
07/03/2019
Last updated
07/03/2023
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