Provider Demographics
NPI:1790480994
Name:WALTON, MONAA (NP)
Entity type:Individual
Prefix:
First Name:MONAA
Middle Name:
Last Name:WALTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 BERWICK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7616
Mailing Address - Country:US
Mailing Address - Phone:443-528-9616
Mailing Address - Fax:
Practice Address - Street 1:898 AIRPORT PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2521
Practice Address - Country:US
Practice Address - Phone:410-768-4386
Practice Address - Fax:888-907-0899
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234837163W00000X, 363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily