Individual
IRENE KAY WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11 DOG HILL RD, DAYVILLE, CT 06241-2106
(860) 779-0321
Mailing address
11 DOG HILL RD, DAYVILLE, CT 06241-2106
(860) 779-0321
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
100280
MT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201907687NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7567
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851682736
—
MT
Enumeration date
04/26/2011
Last updated
10/06/2022
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