Individual
KAREN LYNN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 RETREAT AVE, SUITE 605, HARTFORD, CT 06106-2528
(860) 244-0148
(860) 240-7067
Mailing address
2110 SILAS DEANE HWY, 2ND FL, ROCKY HILL, CT 06067-2313
(860) 258-3470
(860) 571-6800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
003632
CT
363LA2100X
Acute Care Nurse Practitioner
003632
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003632
MEDICAL LICENSE
CT
Enumeration date
07/18/2007
Last updated
07/25/2007
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