Individual provider · Type 1 NPI

Brenda Diane Waller, RN

Registered Nurse · Kayenta, AZ

NPI number 1104233949 Active

Practice location

Hwy 160/163 Building Ka 2010
Kayenta, AZ 86033-0368

Call (928) 697-4100 Map

Fax (928) 697-4029

Mailing address

280 Valley St
Sparta, TN 38583-3210

Specialties and licenses

Taxonomy	Code	License
Registered Nurse Primary	163W00000X	RN0000037956 (TN)
Registered Nurse	163W00000X	NURR34341 (AK)
Emergency Registered Nurse	163WE0003X	37956 (TN)
Emergency Registered Nurse	163WE0003X	NURR34341 (AK)

Registered Nurse: (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 Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1104233949

Brenda Diane Waller, RN's National Provider Identifier is 1104233949, issued on Jul 14, 2014. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Kayenta, AZ. The record was last updated on Jul 14, 2014.