Individual provider · Type 1 NPI

Edward Nicholas Waller, FNP-BC

Family Nurse Practitioner · Cambridge, MA

NPI number 1124672118 Active

Practice location

25 Carleton St
Cambridge, MA 02142-1323

Mailing address

53 N Gate Park
Newton, MA 02465-1645

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XRN2306059 (MA)

Family Nurse Practitioner: Definition to come...

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About NPI 1124672118

Edward Nicholas Waller, FNP-BC's National Provider Identifier is 1124672118, issued on Jul 29, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Cambridge, MA. The record was last updated on Jul 29, 2019.