Individual
CATHERINE B WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
450 BROOKLINE AVE, DANA 3, BOSTON, MA 02215
(617) 632-5464
(617) 582-8350
Mailing address
450 BROOKLINE AVE, DANA 3, BOSTON, MA 02215-5418
(617) 632-5464
(617) 582-8350
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
F381877-1
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
RN270714
MA
Other
Enumeration date
04/24/2007
Last updated
10/28/2015
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