Denise Walter, AGACNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

63349 Issued in WV

Practice address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1000

NPI assigned

Dec 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Denise Deluca Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1306211883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 SAWYER DR",
            "city": "HARPERS FERRY",
            "state": "WV",
            "postal_code": "254255885",
            "telephone_number": "304-676-8468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "DENISE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "63349",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "63349",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WV",
            "license": "63349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DENISE",
            "last_name": "DELUCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tricia Alane Wallace, RN
• Jennifer Anne Waller, RN
• Tammy Kaye Waller, RN
• Margaret A Walls, RN
• Gayle Lynn Walsh
• Ashley Jolynn Ward, BSN RN
• Jeffery Alan Ward, PHARMD
• Shasta Nicole Ward, RN
• William Joseph Ward
• Christine Irene Warner, RN

• Gerontology Nurse Practitioner in Gallup, NM
• Providers in Gallup, NM by specialty
• Gerontology Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.