Provider Demographics
NPI:1083134464
Name:WALTERS, EMILY (CNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MESEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 OUTERBELT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1548
Mailing Address - Country:US
Mailing Address - Phone:614-759-5075
Mailing Address - Fax:614-591-4480
Practice Address - Street 1:81 OUTERBELT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1548
Practice Address - Country:US
Practice Address - Phone:614-759-5075
Practice Address - Fax:614-591-4480
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP.021086363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health