Individual
KRISTEN RAE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4909 S 118TH ST, OMAHA, NE 68137-2213
(402) 397-2010
Mailing address
3101 W 57TH ST, SIOUX FALLS, SD 57108-3162
(605) 371-7000
(605) 371-7199
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1547
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1547
NEBRASKA LICENSE
NE
Enumeration date
05/11/2020
Last updated
05/21/2024
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