Staci L Wall in Fort Wayne - Nurse Practitioner
Staci L Wall - NPI 1629068291
Staci L Wall is a Nurse Practitioner in Fort Wayne, Indiana. Staci L Wall practices all healthcare services and medical treatments related to Nurse Practitioner. 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 |
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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 |
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Provider Enumeration Date | 2005-10-25 |
Last Updated Date | 2018-01-31 |
Provider Mailing Address Detail
Address | 2518 E Dupont Rd |
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City | Fort Wayne |
State | Indiana (IN) |
Post Code | 468251675 |
Phone Number | 2604324400 |
Fax Number | 2609696898 |
Provider's Primary Taxonomy Detail
Speciality | Nurse Practitioner |
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Taxonomy | 363L00000X |
Licence No | 71003769 |
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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 Nurse Practitioner, and the taxonomy code that classifies this field of practice is 363L00000X.
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.