DAVID CLAYTON WALTHALL FNP, MSN, BSN
NPI 1619477965
Nurse Practitioner - Family in Chicago, IL
Active since February 13, 2018
About David Clayton Walthall Fnp, Msn, Bsn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID CLAYTON WALTHALL FNP, MSN, BSN (NPI 1619477965) is an individual family provider in Chicago, Illinois, licensed in Illinois (209.017198) and active in the NPI registry since February 2018.
NPPES Registry Identity
NPI1619477965
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDAVID CLAYTON WALTHALLCredential: FNP, MSN, BSN
Location Address1340 S DAMEN AVEChicago, IL 60608-1169
Mailing Address1340 S Damen AveChicago, IL 60608-1169
Phone(312) 997-7200
Sole ProprietorYes
Enumeration DateFebruary 13, 2018
✔ NPI 1619477965 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.017198
1340 S DAMEN AVE, Chicago, IL 60608
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619477965, enumerated as an "individual" on February 13, 2018.
The provider is located at 1340 S DAMEN AVE CHICAGO, IL 60608 and the phone number is (312) 997-7200.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
