Provider Demographics
NPI:1710028238
Name:WALLS, NANCY MCMORRIS (RN, MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:MCMORRIS
Last Name:WALLS
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-4325
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:6650 CEDAR GROVE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70812-1167
Practice Address - Country:US
Practice Address - Phone:225-526-4325
Practice Address - Fax:225-355-8650
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN084300AP04093363LF0000X
LAAP04093363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1148091Medicaid