Provider Demographics
NPI:1417343765
Name:WALTER, SARAH REBECCA (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:REBECCA
Last Name:WALTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 TRINITY ST STOP A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1766
Mailing Address - Country:US
Mailing Address - Phone:512-495-5300
Mailing Address - Fax:512-495-5680
Practice Address - Street 1:1601 TRINITY ST STOP A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1766
Practice Address - Country:US
Practice Address - Phone:512-495-5300
Practice Address - Fax:512-495-5680
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX793755163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse