Provider Demographics
NPI:1518606367
Name:LLORENS-WALTERS, MIGDALIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MIGDALIA
Middle Name:
Last Name:LLORENS-WALTERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 VOSHAGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2420
Mailing Address - Country:US
Mailing Address - Phone:917-692-6588
Mailing Address - Fax:
Practice Address - Street 1:28 VOSHAGE ST
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2420
Practice Address - Country:US
Practice Address - Phone:917-692-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY430201363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care