Individual
DONNIETRA LA'VERNE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1201 E MICHIGAN AVE STE 240, JACKSON, MI 49201-1855
(517) 205-1591
(517) 782-1713
Mailing address
1201 E MICHIGAN AVE STE 240, JACKSON, MI 49201-1855
(517) 205-1591
(517) 782-1713
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021034592
MI
Other
Enumeration date
08/26/2021
Last updated
10/13/2023
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