Individual
KAY MARIE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP, AGPCNP-BC
Contact information
Practice address
2428 N GRANDVIEW BLVD STE 102, WAUKESHA, WI 53188-6906
(262) 875-5070
Mailing address
PO BOX 474, HARTLAND, WI 53029-0474
(262) 875-5070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10601-33
WI
363LG0600X
Gerontology Nurse Practitioner
Primary
10601-33
WI
Other
Enumeration date
12/01/2020
Last updated
01/21/2025
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