MICA WALTHALL, LPN

Licensed Practical Nurse

Active Individual
NPI: 1417220625

Practice Address

2 MALER LN
Patchogue, NY 11772

Phone: (631) 639-6682

Specialties

Specialty Code Primary License
Licensed Practical Nurse 164W00000X Yes 270772 (NY)

Frequently Asked Questions

NPI 1417220625 is the National Provider Identifier for MICA WALTHALL, LPN, a Licensed Practical Nurse provider located in Patchogue, NY. This NPI was enumerated on February 17, 2012.
MICA WALTHALL, LPN practices at 2 MALER LN, Patchogue, NY 11772.

Quick Facts

NPI
1417220625
Type
Individual
Enumerated
Feb 17, 2012
Last Updated
Feb 17, 2012

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