Kimberly L Waller in Grants Pass - Medical
Kimberly L Waller - NPI 1093782914
Kimberly L Waller is a Medical in Grants Pass, Oregon. Kimberly L Waller practices all healthcare services and medical treatments related to Medical. The NPI Number for Kimberly L Waller is 1093782914. The last update date is 2019-10-28.
Kimberly L Waller's current location address is 1701 Nw Hawthorne Ave, Grants Pass, Oregon. You can contact this provider via phone number 5414713455. The mailing address for Kimberly L Waller is 1701 Nw Hawthorne Ave, Grants Pass, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kimberly L Waller |
|---|---|
| Address | 1701 Nw Hawthorne Ave, Grants Pass, Oregon |
| Phone Number | 5414713455 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1093782914 |
|---|---|
| Provider Enumeration Date | 2006-03-01 |
| Last Updated Date | 2019-10-28 |
Provider Mailing Address Detail
| Address | 1701 Nw Hawthorne Ave |
|---|---|
| City | Grants Pass |
| State | Oregon (OR) |
| Post Code | 975261051 |
| Phone Number | 5414713455 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA842 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100503581 | NV | -- | |
| 100503226 | NV | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kimberly L Waller by the Centers for Medicare & Medicaid Services?
The Kimberly L Waller has been assigned the NPI (National Provider Identifier) 1093782914 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Kimberly L Waller is physically located?
The Kimberly L Waller is situated at the following address: 1701 Nw Hawthorne Ave, Grants Pass, OR 975261051.
What is the Kimberly L Waller's area of specialization and corresponding taxonomy classification?
The Kimberly L Waller's specialty field is Medical, and it falls under the taxonomy code 363Am0700X, which categorizes healthcare providers based on their specialties.
On what date did Kimberly L Waller receive its 1093782914 assignment from the Centers for Medicare & Medicaid Services?
The Kimberly L Waller was assigned its 1093782914 on 2006-03-01, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Kimberly L Waller most recently updated?
The details pertaining to the Kimberly L Waller, including its address, specialty, and other relevant information, were last refreshed on 2019-10-28.
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