MS. SANDRA KAY WALLER (NPI# 1144404807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144404807 |
| Entity Type | Individual |
| Full Name | MS. SANDRA KAY WALLER |
| Credential | LMT |
| Practice Address |
1714 W 23rd Street Suite E Panama City FL 32405-2003 |
| Mailing Address |
2143 W 29th Street Panama City FL 32405-2003 |
| Practice Telephone | 8502761932 |
| Practice Fax Number | 8507698689 |
| Mailing Telephone | 8502761932 |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2007-12-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA36353 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699301465 | Sandra L Waller | Homemaker | 656 Birch Ave, Euclid, OH 44132-2106 | 2020-03-12 |
| 1609277888 | Sandra Waller | Specialist | 3106 Memorial Ave, Lynchburg, VA 24501-3730 | 2014-09-08 |
| 1518090307 | Sandra Fay Waller | Technician | 2129 Rainbow Dr, 242 W Shamrock Street, Pineville, LA 71360-6449 | 2007-03-13 |
| 1043260441 | Sandra D Waller | Nurse Practitioner | 2861 Broad Ave, Memphis, TN 38112-2903 | 2006-05-10 |
| Street Address |
1714 W 23RD STREET SUITE E |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-2003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710599717 | Guishun Jiang | Massage Therapist | 851 Jenks Ave, Panama City, FL 32401-2531 | 2020-08-20 |
| 1811540164 | Josh Brannon | Massage Therapist | 2404 Ruth Hentz Ave, Panama City, FL 32405-2258 | 2019-07-16 |
| 1104377902 | Shellie Peuhs | Massage Therapist | 949 Jenks Ave, 15, Panama City, FL 32401-2580 | 2016-10-18 |
| 1841642279 | Tiffany Dauphin | Massage Therapist | 2726 Canal Ave, Panama City, FL 32405-5723 | 2016-07-11 |
| 1548664659 | Sara Ashlee Tran | Massage Therapist | 508 Airport Rd Ste F, Panama City, FL 32405-4025 | 2014-10-17 |
| 1699026419 | Corinne Marie Seemuth | Massage Therapist | 7623 Shadow Bay Dr, Panama City, FL 32404-2488 | 2012-09-20 |
| 1164786513 | Anh Bui | Massage Therapist | 3212 W 23rd St Ste 2, Panama City, FL 32405-1870 | 2012-06-30 |
| 1811253958 | Jeffrey L Simonton | Massage Therapist | 409 School Ave Lot E6, Panama City, FL 32401-5568 | 2012-04-03 |
| 1851672281 | Angela Margaret Black | Massage Therapist | 9222 James Way, Panama City, FL 32404-5673 | 2011-08-30 |
| 1295022143 | Cheryl Lee Allen | Massage Therapist | 400 W 11th St, Suite F, Panama City, FL 32401-2480 | 2011-06-29 |
| Find all providers in PANAMA CITY | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
Please comment or provide details below to improve the information on MS. SANDRA KAY 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.