Individual provider · Type 1 NPI
Susan P. Walla, APRN
Psychiatric/Mental Health Nurse Practitioner · Gillette, WY
NPI number
1962589747
Active
Practice location
707 W 8th St
Gillette, WY 82716-4108
Fax (888) 852-8319
Mailing address
748 Main St
Lander, WY 82520-3036
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 21112 (MT) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 29650.1122 (WY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
3 other providers at this address
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About NPI 1962589747
Susan P. Walla, APRN's National Provider Identifier is 1962589747, issued on Nov 1, 2006. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Gillette, WY. The record was last updated on Aug 24, 2016.