Provider Demographics
NPI:1508696543
Name:WALTER, ANSLEY (NP)
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 TWISTED NEEDLE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-8787
Mailing Address - Country:US
Mailing Address - Phone:706-910-7349
Mailing Address - Fax:
Practice Address - Street 1:433 TWISTED NEEDLE CT
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-8787
Practice Address - Country:US
Practice Address - Phone:706-910-7349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN249059163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse