Etta Louise Walters, MA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA51649 Issued in FL

Practice address

2222 S Harbor City Blvd
Suite 530
Melbourne, FL 32901-5594

Phone

(321) 723-7716

Fax

(321) 723-0604

NPI assigned

Jul 8, 2008

Last updated

Oct 4, 2011By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1629231873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "address_2": "SUITE 610",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-723-7716",
            "fax_number": "321-723-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 S HARBOR CITY BLVD",
            "address_2": "SUITE 530",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329015594",
            "telephone_number": "321-723-7716",
            "fax_number": "321-723-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ETTA",
        "middle_name": "LOUISE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA51649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin K Wallace, LMHC
• Denise Walleck
• Chrystal A Walls, MSN, FNP
• Robert E. Walsh, PA-C
• Ira M Walter, MSN-ED, APRN, FNP
• Staci Renee Walters, O.D.
• Hsiao Ting Wang
• Yue M Wang, MD
• Warby Parker Inc.
• Amy M Ward, PT

• Massage Therapist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.