KENSIE WALLER (NPI# 1730635681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730635681 |
| Entity Type | Individual |
| Full Name | KENSIE WALLER |
| Other Name | KENSIE WAGNER |
| Credential | FNP |
| Practice Address |
3834 S. Emerson Ave Bldg C, Ste 100 Indianapolis IN 46203 |
| Mailing Address |
Po Box 3299 Carson City NV 89702-3299 |
| Practice Telephone | 3177821577 |
| Practice Fax Number | 3177805538 |
| Mailing Telephone | 3177821577 |
| Mailing Fax Number | 3177805538 |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2018-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28216896A | IN | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71006978A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | PENDING | 05 | |
| IN | ANTHEM PROVIDER NUMBER | PENDING | 01 |
| Street Address |
3834 S. EMERSON AVE BLDG C, STE 100 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194362665 | Yvonne Irene Wince | Pharmacist | 608 Twin Aire Dr, Indianapolis, IN 46203 | 2019-12-04 |
| 1629285820 | 21st Century Charter School At Fountain Square | Local Education Agency (LEA) | 1615 South Barth Ave, Indianapolis, IN 46203 | 2007-05-17 |
| 1912124918 | Richard Walter James | Chiropractor | 3850 S Emerson, Suite F, Indianapolis, IN 46203 | 2007-04-19 |
| 1245386655 | Gary Richard Billingsley | Chiropractor | 4940 S Emerson Ave, Indianapolis, IN 46203 | 2007-01-26 |
| 1952452815 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 2630 S Keystone Ave, Indianapolis, IN 46203 | 2007-01-16 |
| 1245324755 | Rtc Resource Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 1404 South State Avenue, Indianapolis, IN 46203 | 2006-10-02 |
| 1548776925 | Erin Tofani | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2017-12-20 |
| 1114464575 | Abigail G Boris | Registered Nurse | 3834 S Emerson Ave, Bldg C Ste 100, Indianapolis, IN 46203 | 2017-01-24 |
| 1285184481 | Kelli Joy Bovenkerk | Nurse Practitioner | 3834 S Emerson Ave, Building C, Suite 100, Indianapolis, IN 46203 | 2016-10-12 |
| 1346626876 | Thomas Edwin Puckett Jr. | Nurse Practitioner | 3834 S Emerson Ave, Bldg C Ste 100, Indianapolis, IN 46203 | 2015-08-06 |
| Find all providers in zip 46203 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1922614965 | Children Express Care Clinic LLC | Nurse Practitioner | 5435 Emerson Way Ste 110, Indianapolis, IN 46226-1470 | 2020-09-16 |
| 1255956272 | Heather Nicole Zore | Nurse Practitioner | 9240 N Meridian St Ste 225, Indianapolis, IN 46260-1880 | 2020-06-15 |
| 1457976615 | Adam Weir | Nurse Practitioner | 960 E Washington St, Indianapolis, IN 46202-3981 | 2020-06-13 |
| 1457975740 | Ayee Teah Bleemie | Nurse Practitioner | 429 E Vermont St Ste 100, Indianapolis, IN 46202-3688 | 2020-06-02 |
| 1689294357 | May Josefa Ishikawa | Nurse Practitioner | 705 Riley Hospital Dr Ste 2240, Indianapolis, IN 46202-5109 | 2020-04-22 |
| 1760001200 | John Shaver | Nurse Practitioner | 3750 N Meridian St Ste 100, Indianapolis, IN 46208-4300 | 2020-04-14 |
| 1851931000 | Robin L Petit | Nurse Practitioner | 6925 S Harding St Ste B-1, Indianapolis, IN 46217-4114 | 2020-01-15 |
| 1952941577 | Andreya Beckett | Nurse Practitioner | 3500 Depauw Blvd Ste 1041, Indianapolis, IN 46268-6125 | 2020-01-11 |
| 1053950105 | Shannon Malecki | Nurse Practitioner | 550 University Blvd Ste 5630, Indianapolis, IN 46202-5149 | 2020-01-06 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46203 |
Please comment or provide details below to improve the information on KENSIE WALLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.