RACHEL WATSON WALLER (NPI# 1194095125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194095125 |
| Entity Type | Individual |
| Full Name | RACHEL WATSON WALLER |
| Credential | APRN, PNP |
| Practice Address |
766 Hl Ross Dr Monticello AR 71655 |
| Mailing Address |
Po Box 509 Dermott AR 71638-0509 |
| Practice Telephone | 8703676246 |
| Practice Fax Number | 8559267383 |
| Mailing Telephone | 8705385414 |
| Mailing Fax Number | 8705385412 |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2017-07-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
A005238 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
RN108921-AP06666 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | PRESCRIPTIVE AUTHORITY - LOUISIANA STATE BOARD OF NURSING | 060129 | 01 |
| LA | 2177079 | 05 | |
| LA | LOUISIANA DRIVERS LICENSE | 007095465 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205425 | Rachel Waller | Physical Therapist | 3901 University Blvd S, Jacksonville, FL 32216-4312 | 2020-08-16 |
| 1871555680 | Rachel R Waller | Internal Medicine | 1250 E Marshall St, Internal Medicine, Richmond, VA 23298-5051 | 2006-04-05 |
| Street Address |
766 HL ROSS DR |
| City | MONTICELLO |
| State | AR |
| Zip Code | 71655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548464993 | Fredy H Cordova | Family Medicine | 766 Hl Ross Dr, Monticello, AR 71655 | 2007-06-11 |
| 1174071583 | April Brandy Glasscock | Nurse Practitioner | 766 Hl Ross Dr, Monticello, AR 71655 | 2016-09-14 |
| 1881912137 | Nina Nicole Jefferson | Psychologist | 766 Hl Ross Dr, Monticello, AR 71655 | 2010-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104462712 | Ashley Leanna Huitt | Nurse Practitioner | Drew Memorial Health System, 778 Scogin Drive, Monticello, AR 71655 | 2019-11-19 |
| 1043716525 | Mmc Rural Health Clinics, Pllc | Clinic/Center | 733 Roberts Drive, Monticello, AR 71655 | 2018-04-03 |
| 1760991640 | Kristen Leigh Harvey | Registered Nurse | 162 University Heights Drive, Monticello, AR 71655 | 2017-09-24 |
| 1124578075 | Morgan Family Dentistry, Pllc | Dentist | 501 Hwy 425 South, Monticello, AR 71655 | 2016-10-04 |
| 1770039752 | Jesse Bone | Nurse Practitioner | 766 Hl Ross Drive, Monticello, AR 71655 | 2016-08-30 |
| 1487050076 | Sara Tucker | Speech-Language Pathologist | 178 W. College Street, Monticello, AR 71655 | 2014-11-10 |
| 1164859203 | Dustin Clint Eubanks | Chiropractor | 604 A West Bolling Street, Monticello, AR 71655 | 2013-10-03 |
| 1194009431 | Rebecca Shea Woodall | Social Worker | 600 Highway 425 North, Suite B, Monticello, AR 71655 | 2011-10-05 |
| 1568744522 | Britney Leigh Box | Occupational Therapist | 178 W College St, Monticello, AR 71655 | 2011-09-15 |
| 1740415611 | Julia Danielle Nicholson | Family Medicine | 906 Roberts Drive, Monticello, AR 71655 | 2009-05-21 |
| Find all providers in zip 71655 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324216 | Taira Nicole Bernard | Nurse Practitioner | 6424 The Divide Pkwy Apt 106, Little Rock, AR 72223-5861 | 2020-04-07 |
| 1568932119 | Katie Jones | Nurse Practitioner | 1children's Way, Little Rock, AR 72211 | 2018-11-27 |
| 1386152163 | Sara Jane Brown | Nurse Practitioner | 4000 Linwood Dr Ste H, Paragould, AR 72450-7224 | 2018-01-16 |
| 1194178376 | Amy Hodges | Nurse Practitioner | 172 Highway 62 W, Salem, AR 72576-8059 | 2016-07-22 |
| 1265824841 | Ashley Gayle Vaughan | Nurse Practitioner | 7303 Rogers, Ave 201, Pediatric Partners, Fort Smith, AR 72903-4112 | 2015-02-19 |
| 1215333075 | Lisa Lavon Fields | Nurse Practitioner | 5434 W Walsh Ln, Rogers, AR 72758-8946 | 2014-11-06 |
| 1689923831 | Joanna Lowery | Nurse Practitioner | 3 Childrens Way, Little Rock, AR 72202-3500 | 2012-09-04 |
| 1881941417 | Denice Marie Bozeman | Nurse Practitioner | 1 Childrens Way # 707, Little Rock, AR 72202-3500 | 2012-08-14 |
| 1699038711 | Jennifer Ellen Murphree | Nurse Practitioner | 1 Children's Way, St # 653, Little Rock, AR 72202 | 2012-06-22 |
| 1255579124 | Kimberly Ann Grundy | Nurse Practitioner | 800 Marshall St # 512-3, Little Rock, AR 72202-3510 | 2009-01-29 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 71655 |
Please comment or provide details below to improve the information on RACHEL WATSON 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.