Provider Demographics
NPI:1194045765
Name:WALZ, DEBRA ANN (WHNP, AOCNP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:WALZ
Suffix:
Gender:F
Credentials:WHNP, AOCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2618
Mailing Address - Country:US
Mailing Address - Phone:315-361-2381
Mailing Address - Fax:315-361-2398
Practice Address - Street 1:604 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2618
Practice Address - Country:US
Practice Address - Phone:315-361-2381
Practice Address - Fax:315-361-2398
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420973363LW0102X
NY370044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health