Provider Demographics
NPI:1417930819
Name:WALER REED ARMY MEDICAL CENTER
Entity Type:Organization
Organization Name:WALER REED ARMY MEDICAL CENTER
Other - Org Name:DEWITT ARMY HOSPITAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN ANP
Authorized Official - Phone:703-805-0046
Mailing Address - Street 1:5773 WESTCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-1147
Mailing Address - Country:US
Mailing Address - Phone:703-971-3497
Mailing Address - Fax:
Practice Address - Street 1:9501 FARRELL RD
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-805-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017001553261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty