Provider Demographics
NPI:1225776685
Name:WALTERS, LORRAINE LIN (APRN (CNS))
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:LIN
Last Name:WALTERS
Suffix:
Gender:F
Credentials:APRN (CNS)
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:LIN
Other - Last Name:DELANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5955 ZEAMER AVE.
Mailing Address - Street 2:PERINATAL NURSING SERVICES UNIT
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99506-3700
Mailing Address - Country:US
Mailing Address - Phone:907-580-1422
Mailing Address - Fax:
Practice Address - Street 1:5955 ZEAMER AVE.
Practice Address - Street 2:PERINATAL NURSING SERVICES UNIT
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506-3700
Practice Address - Country:US
Practice Address - Phone:907-580-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX696561163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherNONE