ELYSSA N WALLER NPI 1962947960

NPI Information

NPI: 1962947960
Provider Name: ELYSSA N WALLER
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
4729 HIGHWAY 90
MARIANNA, FL
ZIP 32446
Phone: (850) 482-2373
Get Directions

ELYSSA N WALLER is a chiropractor in Marianna, FL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. ELYSSA N WALLER NPI is 1962947960. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4729 HIGHWAY 90
MARIANNA, FL
ZIP 32446-820
Phone: (850) 482-2373
Fax: (850) 482-2395

The provider's authorized official is Elyssa Waller .
The authorized official title is Owner and has the following contact phone number (850) 482-2373.

The enumeration date for this NPI number is 12/29/2016 and was last updated on 12/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		CH9060	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	U1XD4	OTHER		FLORIDA BLUE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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