Provider Demographics
NPI:1003082363
Name:WALLS, SHEILA REECE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:REECE
Last Name:WALLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:S
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:MOUNT ZION
Mailing Address - State:GA
Mailing Address - Zip Code:30150-0658
Mailing Address - Country:US
Mailing Address - Phone:770-836-0103
Mailing Address - Fax:770-834-8828
Practice Address - Street 1:4248 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-7602
Practice Address - Country:US
Practice Address - Phone:770-836-0103
Practice Address - Fax:770-834-8828
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN054676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily