Annette Faulkner Wall, ARNP
Nurse Practitioner, Acute Care in Jacksonville, FL. Individual provider (NPI-1).
NPI number1366977902
StatusActive
Last updated in NPPESApr 20, 2017
Details
- NPI
- 1366977902
- Entity type
- Individual (NPI-1)
- Name
- Annette Faulkner Wall
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 20, 2017
- Last updated
- Apr 20, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2100X | Nurse Practitioner, Acute Care | 1365492 | FL | Yes |
Practice location
14601 Swansea CtJacksonville, FL 32258-4446
Phone 904-616-4648
Mailing address
14601 Swansea CtJacksonville, FL 32258-4446
Phone 904-616-4648
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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