Staci L Wall is a Registered Nurse in Fort Wayne, Indiana. Staci L Wall practices all healthcare services and medical treatments related to Registered Nurse. The NPI Number for Staci L Wall is 1629068291. The last update date is 2018-01-31.
Staci L Wall's current location address is 2518 E Dupont Rd, Fort Wayne, Indiana. You can contact this provider via phone number 2604324400 and fax number 2609696898. The mailing address for Staci L Wall is 2518 E Dupont Rd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Staci L Wall |
|---|---|
| Address | 2518 E Dupont Rd, Fort Wayne, Indiana |
| Phone Number | 2604324400 |
| Fax Number | 2609696898 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1629068291 |
|---|---|
| Provider Enumeration Date | 2005-10-25 |
| Last Updated Date | 2018-01-31 |
Provider Mailing Address Detail
| Address | 2518 E Dupont Rd |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468251675 |
| Phone Number | 2604324400 |
| Fax Number | 2609696898 |
Provider's Primary Taxonomy Detail
| Speciality | Registered Nurse |
|---|---|
| Taxonomy | 163W00000X |
| Licence No | 28086186 |
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Definition: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200338300 | IN | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Staci L Wall by the Centers for Medicare & Medicaid Services?
The Staci L Wall has been issued the NPI (National Provider Identifier) 1629068291 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Staci L Wall is physically located?
The Staci L Wall is situated at the following address: 2518 E Dupont Rd, Fort Wayne, IN 468251675.
What is Staci L Wall's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Staci L Wall is Registered Nurse, and the taxonomy code that classifies this field of practice is 163W00000X.
On what date did Staci L Wall receive its 1629068291 assignment from the Centers for Medicare & Medicaid Services?
The Staci L Wall was assigned its 1629068291 on 2005-10-25, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Staci L Wall's details last updated?
The information pertaining to the Staci L Wall, including its address, specialty, and other details, was most recently updated on 2018-01-31.