Individual
MRS. MONICA M WAHLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
(541) 706-2398
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900
(541) 706-2398
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
200150011NP-FNP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201391720NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000164
—
OR
01
—
000188021
IND BLUE CROSS
OR
01
—
500027207
IND RAILROAD
OR
01
—
J406428
IND PACSOURCE
OR
Enumeration date
02/08/2006
Last updated
05/04/2022
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