Provider Demographics
NPI:1225265788
Name:WALTERS, PATRICIA LYNNE (MBCHB,MFOM,MRCGP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LYNNE
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MBCHB,MFOM,MRCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY AEROMEDICAL RESEARCH LABORATORY
Mailing Address - Street 2:FORT RUCKER
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36362-0577
Mailing Address - Country:US
Mailing Address - Phone:334-255-6815
Mailing Address - Fax:334-255-7798
Practice Address - Street 1:US ARMY AEROMEDICAL RESEARCH LABORATORY
Practice Address - Street 2:FORT RUCKER
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36362-0577
Practice Address - Country:US
Practice Address - Phone:334-255-6815
Practice Address - Fax:334-255-7798
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider