Walsh, John
Walsh, John is an sole proprietor health care provider with primary practice located at 621 Memorial Dr Ste 502 , South Bend IN 46601-1075. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Walsh, John can be contacted via phone (574) 647-5875.Contact Information
Primary practice address
621 Memorial Dr Ste 502
South Bend IN 46601-1075
Phone: (574) 647-5875
Fax: (574) 647-5878
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 71008427A | Indiana |
Profile Details
| NPI number | 1316427560 |
|---|---|
| LBN Legal business name | Walsh, John |
| Credentials | AG-ACNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2018 |
| Last updated | Apr 28th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316427560 | NPPES |
| Indiana | MEDICAID | 300021695 |
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