Nicole Wall, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN.528861 Issued in OH

Practice address

3382 Paris Blvd
Westerville, OH 43081-4260

Phone

(614) 963-2731

NPI assigned

May 22, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Secure Haven Behavioral Health Care Inc

  • Community/Behavioral Health Agency
  • Westerville, OH
  • NPI 1871173880
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1255170809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3382 PARIS BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3382 PARIS BLVD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814260",
            "telephone_number": "614-963-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "NICOLE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.528861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Ann Walker, RPH
• Paris Walker
• Shamara Walker, LISW
• Rachelle Walko
• Mackenzie Wall, LPC
• Abbe Marie Wallace, LMT, NMT
• Elizabeth Wallace
• Sarah Jayne Wallace, PSYD
• Renee Walling, BA
• Valarie Walls

• Registered Nurse in Westerville, OH
• Providers in Westerville, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.