Individual provider · Type 1 NPI

Shaelyn Davis Waller, MSN, CPNP-AC, CHPPN

Pediatric Nurse Practitioner · Philadelphia, PA

NPI number 1053012542 Active

Practice location

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Call (215) 590-1000 Map

Mailing address

3815 Haverford Ave Apt 3
Philadelphia, PA 19104-2896

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XSP027298 (PA)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1053012542

Shaelyn Davis Waller, MSN, CPNP-AC, CHPPN's National Provider Identifier is 1053012542, issued on Mar 13, 2023. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 13, 2023.