Individual
CHRISTINE M WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
8901 W LINCOLN AVE, WEST ALLIS, WI 53227-2409
(414) 328-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3478
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05575
CRNA RECERTIFICATION CARD
—
05
—
44331800
—
WI
Enumeration date
12/13/2005
Last updated
12/16/2025
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