Suzanne Marie Wall, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024165072 Issued in VA

Practice address

BLDG 1806 Branch Medical Clinic
Naval Weapons Station
Yorktown, VA 23691

Phone

(757) 953-8430

Fax

(757) 953-8450

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1275529570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "address_2": "NAVAL WEAPONS STATION",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236900090",
            "telephone_number": "757-953-8430",
            "fax_number": "757-953-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 1806 BRANCH MEDICAL CLINIC",
            "address_2": "NAVAL WEAPONS STATION",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "23691",
            "telephone_number": "757-953-8430",
            "fax_number": "757-953-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024165072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Waldron, OD
• Walgreen Co (Walgreens #10453)
• Walgreen Co (Walgreen# 09811)
• Alexandra V Walker
• Ynez Walker, RBT
• Laurence Allen Warren, DDS
• Chelsea Davenport Washington, PH.D
• Corrial Watts
• Elizabeth Ann Webb
• Elaine Weidle

• Family Nurse Practitioner in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.