Katie Waller
Nurse Practitioner, Psych/Mental Health in Fort Smith, AR. Individual provider (NPI-1).
NPI number1043074396
StatusActive
Last updated in NPPESFeb 7, 2024
Details
- NPI
- 1043074396
- Entity type
- Individual (NPI-1)
- Name
- Katie Waller
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 7, 2024
- Certification date
- Feb 7, 2024
- Last updated
- Feb 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 227616 | AR | Yes |
Practice location
3111 S 70th StFort Smith, AR 72903-5017
Phone 903-749-1755
Mailing address
1014 Red Oak StElkins, AR 72727-7201
Phone 903-749-1755
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