KANDIE A WALLER (NPI# 1235563297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235563297 |
| Entity Type | Individual |
| Full Name | KANDIE A WALLER |
| Credential | NP-C |
| Practice Address |
5400 Martin Luther King Jr Blvd Houston TX 77021-3010 |
| Mailing Address |
Po Box 66308 Houston TX 77266-6308 |
| Practice Telephone | 2816282050 |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2014-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
772445 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | AANP CERTIFIED FNP ID# | F0713843 | 01 |
| TX | 080462703 | 05 |
| Street Address |
5400 MARTIN LUTHER KING JR BLVD |
| City | HOUSTON |
| State | TX |
| Zip Code | 77021-3010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447503792 | Legacy Community Health Services, Inc | Clinic/Center | 5400 Martin Luther King Jr Blvd, Houston, TX 77021-3010 | 2012-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700409331 | Chinyere Eigege | Social Worker | 5334 Keystone St, Houston, TX 77021 | 2020-05-18 |
| 1821625815 | Essential Body Bar, Pllc | Nurse Practitioner | 5751 Blythwood Street, Suite 200, Houston, TX 77021 | 2020-03-27 |
| 1699311944 | Devoted Angels LLC | Meals | 7807 Tierwester Street, Houston, TX 77021 | 2019-11-21 |
| 1013495696 | Ethel Row, LLC | Counselor | 1 Hermann Park Court, Unit 645, Houston, TX 77021 | 2018-08-05 |
| 1023594504 | Daniel Todd Jankowski | Dentist | 6102 Scott St, Houston, TX 77021 | 2018-07-17 |
| 1861988164 | Houston Area Community Services, Inc | Clinic/Center | 4405 Griggs Road, Houston, TX 77021 | 2018-07-10 |
| 1942739123 | Optimcurea LLC | Internal Medicine | 2440 D Charleston Street, Houston, TX 77021 | 2017-06-09 |
| 1699229138 | Angela Dobbins | Psychologist | 5400 Griggs Rd Ste 101, Houston, TX 77021 | 2016-08-13 |
| 1194180877 | Alina Leigh | Nurse Practitioner | 5737 Cullen Suite 200, Houston, TX 77021 | 2015-12-22 |
| 1336514751 | Joshua In Home Quality Health Care | In Home Supportive Care | 3822 Southlawn Street, 3, Houston, TX 77021 | 2015-12-10 |
| Find all providers in zip 77021 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255162 | Shaida Rahmatinick | Nurse Practitioner | 1515 W 22nd St, Houston, TX 77008-1501 | 2020-11-08 |
| 1104426311 | Erin Krim Gordon | Nurse Practitioner | 2202 Quenby St, Houston, TX 77005-1502 | 2020-10-27 |
| 1003415902 | Hope Ozumba | Nurse Practitioner | 8544 Dairy View Ln, Houston, TX 77072-3907 | 2020-10-21 |
| 1487253761 | Khanh Vu Phuong Nguyen | Nurse Practitioner | 13218 Bellaire Bld, Houston, TX 77083 | 2020-10-19 |
| 1962001362 | Eshcol Clinic | Nurse Practitioner | 9935 Bissonnet St Unit B, Houston, TX 77036-8413 | 2020-10-19 |
| 1013516483 | Shazia Mominkhawaja | Nurse Practitioner | 2222 Greenhouse Rd Ste 400, Houston, TX 77084-7288 | 2020-10-18 |
| 1851908610 | Iyobo Elegon | Nurse Practitioner | 8511 Dawnridge Dr, Houston, TX 77071-2441 | 2020-09-25 |
| 1548877541 | Lifespan Psychiatry and Wellness Center Pllc | Nurse Practitioner | 8700 Commerce Park Dr Ste 220, Houston, TX 77036-7431 | 2020-09-24 |
| 1811503345 | Alyssa Cory Hildebrand | Nurse Practitioner | 2450 Fondren Rd Ste 111, Houston, TX 77063-2314 | 2020-09-21 |
| 1245846088 | Adriana Ortiz | Nurse Practitioner | 7218 Shady Corners Ln, Houston, TX 77040-4733 | 2020-09-17 |
| Find all providers in HOUSTON | ||||
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| 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.