Provider Demographics
NPI:1942476064
Name:WALSH, EILEEN P (MSN,FNP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:P
Last Name:WALSH
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-3318
Mailing Address - Country:US
Mailing Address - Phone:818-556-3939
Mailing Address - Fax:818-887-5577
Practice Address - Street 1:212 S MAPLE DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4014
Practice Address - Country:US
Practice Address - Phone:424-221-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily