Individual provider · Type 1 NPI

Brent Steven Waller, FNP-BC

Family Nurse Practitioner · Anaheim, CA

NPI number 1356973432 Active

Practice location

3400 W Ball Rd Ste 207
Anaheim, CA 92804-3737

Call (714) 683-5100 Map

Mailing address

766 S Langtree Ln
Anaheim, CA 92807-4897

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95013038 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1356973432

Brent Steven Waller, FNP-BC's National Provider Identifier is 1356973432, issued on Feb 6, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Anaheim, CA. The record was last updated on Feb 7, 2020.