Individual
MRS. MIRIAM ELIZABETH WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9154 US ROUTE 60, ONA, WV 25545-7416
(304) 733-9430
(304) 733-9439
Mailing address
201 GREEN OAK DR, HUNTINGTON, WV 25705-3719
(304) 544-3362
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
63047
WV
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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