Individual provider · Type 1 NPI

Donna Van Bladel Wall, NP

Nurse Practitioner · Hiram, GA

NPI number 1184603045 Active

Practice location

144 Bill Carruth Pkwy Ste 3100
Hiram, GA 30141-3819

Fax (678) 581-7110

Mailing address

531 Roselane St NW Ste 710
Marietta, GA 30060-6975

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XAPRN-NP134321 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1184603045

Donna Van Bladel Wall, NP's National Provider Identifier is 1184603045, issued on Jan 10, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Hiram, GA. The record was last updated on Oct 20, 2025.