DELESA SHANA KAY WALDEN (NPI# 1902413636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902413636 |
| Entity Type | Individual |
| Full Name | DELESA SHANA KAY WALDEN |
| Practice Address |
200 Medical Park Blvd Petersburg VA 23805-9274 |
| Mailing Address |
1900 Tolbert Ter Apt 104 Chester VA 23836-2823 |
| Practice Telephone | 8047655000 |
| Mailing Telephone | 9549824985 |
| Enumeration Date | 2020-09-27 |
| Last Update Date | 2020-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
0001268158 | VA | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024180176 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 MEDICAL PARK BLVD |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-9274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992339436 | Amy Kathryn Lansing | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-02-24 |
| 1588296453 | Erin Elise Layne | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-02-10 |
| 1295374643 | Crystal Leigh Maddox | Physical Therapist | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2020-01-02 |
| 1366081911 | Joshua Paul Pidcoe | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-12-31 |
| 1720623853 | Bon Secours Mercy Health Petersburg LLC | General Acute Care Hospital | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-11-13 |
| 1144874686 | Nina Thi Ong-pham | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-08-01 |
| 1720543507 | Martina Rochelle Washington | Specialist/Technologist, Other | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2019-02-05 |
| 1356812242 | Ams Virginia Pllc | Nurse Anesthetist, Certified Registered | 200 Medical Park Blvd, Petersburg, VA 23805 | 2018-12-17 |
| 1841761079 | Erin Collins | Physician Assistant | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2018-12-16 |
| 1265900260 | Casey Brennan | Nurse Practitioner | 200 Medical Park Blvd, Petersburg, VA 23805-9274 | 2018-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 163WM0705X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003236 | Lonnie R Thomas Jr. | Registered Nurse | 5520 Murphy Rd, Vansant, VA 24656-7886 | 2020-11-03 |
| 1013518653 | Rachelle Anne Torres Bullard | Registered Nurse | 8930 Mayhew Ct, Lorton, VA 22079-4722 | 2020-11-02 |
| 1013522283 | Jacob Anthony Orrino | Registered Nurse | 2810 S Wakefield St Unit C, Arlington, VA 22206-1113 | 2020-09-14 |
| 1548881238 | Nicole Haliday | Registered Nurse | 700 Baker Rd Ste 103, Virginia Beach, VA 23462-1077 | 2020-05-04 |
| 1740819374 | Natasha Ramey | Registered Nurse | 6801 Gov George C Peery Highway, Richlands, VA 24641 | 2020-04-06 |
| 1841825726 | Gracia Nseya North | Registered Nurse | 13223 Wrenn House Ln, Herndon, VA 20171-3958 | 2020-03-11 |
| 1124564463 | Josie Pierre-louis | Registered Nurse | 13620 Brandy Oaks Dr, Chesterfield, VA 23832-2700 | 2017-01-10 |
| 1700256211 | Nicholas Gene Parks | Registered Nurse | 6144 Rolfe Ave, Norfolk, VA 23508-1026 | 2015-09-28 |
| 1497124945 | Krystal Bauman | Registered Nurse | 6008 Fox Haven Ct, Woodbridge, VA 22193-4008 | 2015-09-15 |
| 1760742175 | Samantha Carey | Registered Nurse | 11001 Royal Mews Ct, Chester, VA 23831-1297 | 2012-05-18 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
Please comment or provide details below to improve the information on DELESA SHANA KAY WALDEN.
| 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.