Provider Demographics
NPI:1831961440
Name:WALTI, DEANNA DAWN (RN, FNP-BC)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DAWN
Last Name:WALTI
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6189 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1627
Mailing Address - Country:US
Mailing Address - Phone:614-271-3214
Mailing Address - Fax:
Practice Address - Street 1:6189 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1627
Practice Address - Country:US
Practice Address - Phone:380-390-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.485038163W00000X
OHAPRN.CNP.0034547363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse