Provider Demographics
NPI:1710028238
Name:WALLS, NANCY MCMORRIS (RN, MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MCMORRIS
Last Name:WALLS
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 GLEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70812-1832
Mailing Address - Country:US
Mailing Address - Phone:225-355-7284
Mailing Address - Fax:225-356-1616
Practice Address - Street 1:7055 GLEN OAKS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-1832
Practice Address - Country:US
Practice Address - Phone:225-355-7284
Practice Address - Fax:225-356-1616
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN084300AP04093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1148091Medicaid