Provider Demographics
NPI:1932685344
Name:WALDEN, WILLIAM ANDREW (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ANDREW
Last Name:WALDEN
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9027 OAK HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2078
Mailing Address - Country:US
Mailing Address - Phone:423-544-5084
Mailing Address - Fax:
Practice Address - Street 1:2205 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3230
Practice Address - Country:US
Practice Address - Phone:423-698-2435
Practice Address - Fax:423-697-6173
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000195463163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse