Provider Demographics
NPI:1982690848
Name:WALSH, NANCY JOY (RN, CS, ANP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOY
Last Name:WALSH
Suffix:
Gender:F
Credentials:RN, CS, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 PALUXY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5655
Mailing Address - Country:US
Mailing Address - Phone:817-573-8805
Mailing Address - Fax:817-279-9515
Practice Address - Street 1:1318 PALUXY RD
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-5655
Practice Address - Country:US
Practice Address - Phone:817-573-8805
Practice Address - Fax:817-279-9515
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225534363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088264902Medicaid
TX500009255OtherRAILROAD MEDICARE
TXNP7043OtherBCBS
TX500009255OtherRAILROAD MEDICARE
TXNP7043OtherBCBS