Walton, Renae Michelle

Walton, Renae Michelle is an individual health care provider with primary practice located at 15080 Idlewild Rd Ste F , Matthews NC 28104-3601. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Walton, Renae Michelle can be contacted via phone (704) 579-1415.

Contact Information

Primary practice address
15080 Idlewild Rd Ste F Matthews NC 28104-3601
Phone: (704) 579-1415
Fax: (704) 323-7209
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 5004002 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 50042 North Carolina

Profile Details

NPI number 1639378706
LBN Legal business name Walton, Renae Michelle
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Jul 6th, 2022 - about 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639378706 NPPES
North Carolina Other 2593282 MEDICARE INDIVIDUAL NUMBER

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