Provider Demographics
NPI:1982189262
Name:SCHLUNDT-CAPPS, WALDEN BROOK (NP-NURSE PRACTITIONE)
Entity Type:Individual
Prefix:MR
First Name:WALDEN
Middle Name:BROOK
Last Name:SCHLUNDT-CAPPS
Suffix:
Gender:M
Credentials:NP-NURSE PRACTITIONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4913 DEARFOOT PARKWAY
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173
Mailing Address - Country:US
Mailing Address - Phone:205-873-3200
Mailing Address - Fax:205-655-5059
Practice Address - Street 1:4913 DEARFOOT PARKWAY
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173
Practice Address - Country:US
Practice Address - Phone:205-873-3200
Practice Address - Fax:205-655-5059
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily