Provider Demographics
NPI:1558414052
Name:WALTHER, CHRISTINE N (ANP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:N
Last Name:WALTHER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 S GOODMAN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2078
Mailing Address - Country:US
Mailing Address - Phone:585-244-0674
Mailing Address - Fax:585-244-3183
Practice Address - Street 1:26 S GOODMAN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2078
Practice Address - Country:US
Practice Address - Phone:585-244-0674
Practice Address - Fax:585-244-3183
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300108363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health