MR. KEVIN ALAN WALL (NPI# 1386292357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386292357 |
| Entity Type | Individual |
| Full Name | MR. KEVIN ALAN WALL |
| Credential | FNP |
| Practice Address |
200 Front St Ste C Vestal NY 13850-1559 |
| Mailing Address |
3011 State Route 41 Cincinnatus NY 13040-2215 |
| Practice Telephone | 6072395694 |
| Mailing Telephone | 6073459992 |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
344995 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730709569 | Kevin M Wall | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2020-04-22 |
| 1376003350 | Kevin Wall | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2019-03-25 |
| 1710135199 | Kevin Wall | Physical Therapy Assistant | 307 N 5th St, Maryville, TN 37804-2921 | 2008-08-28 |
| 1760515035 | Kevin S Wall | Dentist | 340 Fairfield Ave, Bellevue, KY 41073-1175 | 2007-03-14 |
| 1285673087 | Kevin K Wall | Family Medicine | 4101 Anderson Ave, Manhattan, KS 66503-7588 | 2006-06-06 |
| 1508843335 | Kevin S. Wall | Preventive Medicine | 1661 Saint Anthony Ave, Saint Paul, MN 55104-3733 | 2005-12-22 |
| 1932196367 | Kevin Ray Wall | Chiropractor | 3011 S Lindsay Rd Ste 101, Gilbert, AZ 85295 | 2005-09-30 |
| Street Address |
200 FRONT ST STE C |
| City | VESTAL |
| State | NY |
| Zip Code | 13850-1559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376179895 | Shannen Elizabeth Box | Physician Assistant | 200 Front St Ste C, Vestal, NY 13850-1559 | 2020-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669018800 | Debbie Sue Maerz | Registered Nurse | Vestal Hills Elementary School, 709 Country Club Road, Vestal, NY 13850 | 2019-11-22 |
| 1770144511 | Janice Cecilia Forsberg | Registered Nurse | Clayton Avenue Elementary School, 209 Clayton Avenue, Vestal, NY 13850 | 2019-06-24 |
| 1922514447 | Christopher Lopez | Optometrist | 132 S Jensen Rd, Vestal, NY 13850 | 2017-12-20 |
| 1720503725 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3701 Vestal Pkwy E Ste 4, Vestal, NY 13850 | 2017-08-10 |
| 1013368554 | Ying Fang Zhao | Nurse Practitioner | 404 Apine Drive, Vestal, NY 13850 | 2016-06-27 |
| 1689086308 | Jeff Farinella | Physical Therapist | 1715 Castle Gardes Road, Vestal, NY 13850 | 2014-05-29 |
| 1548689722 | Hamad Saleemi | Physical Medicine & Rehabilitation | 4433 Vestal Pkwy E Fl 1, Vestal, NY 13850 | 2014-04-15 |
| 1518230325 | Sahar F Mahmoud | Optometrist | 3900 Vestal Parkway East, Vestal, NY 13850 | 2012-02-10 |
| 1316221393 | Sharyn Marie Fine | Occupational Therapist | 337 Jones Road, Vestal, NY 13850 | 2011-10-07 |
| 1144504218 | Catherine Ann Willis | Speech-Language Pathologist | 709 Country Club Rd, Vestal, NY 13850 | 2011-10-06 |
| Find all providers in zip 13850 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274997 | Rachel Lynn Devine | Nurse Practitioner | 3101 Shippers Rd Ste 202, Vestal, NY 13850-2082 | 2020-08-01 |
| 1174158695 | Annette Marie Wiesner | Nurse Practitioner | 225 Vestal Pkwy E, Vestal, NY 13850-1629 | 2020-03-04 |
| 1548715410 | Yao Zheng | Nurse Practitioner | 3215 Burris Rd Apt D32, Vestal, NY 13850-2890 | 2016-08-22 |
| 1013368554 | Ying Fang Zhao | Nurse Practitioner | 404 Apine Drive, Vestal, NY 13850 | 2016-06-27 |
| 1427175223 | Susan M. Seibold-simpson | Nurse Practitioner | 149 Vestal Pkwy W, Vestal, NY 13850-1543 | 2007-03-25 |
| 1346338506 | Yvonne Lozano Chesna | Nurse Practitioner | 2220 Vestal Pkwy E Fl 2, Vestal, NY 13850 | 2006-10-11 |
| 1932180072 | Frances Anne Munroe | Nurse Practitioner | 3101 Shippers Rd, Vestal, NY 13850-2080 | 2005-11-07 |
| 1922606110 | Brittany Wingerter | Nurse Practitioner | 4417 Vestal Pkwy E, Vestal, NY 13850-3556 | 2020-10-12 |
| 1851903215 | Kwamia Sanford | Nurse Practitioner | 4417 Vestal Pkwy E, Vestal, NY 13850-3556 | 2020-08-18 |
| 1346801206 | Broome Family Nurse Practitioners PC | Nurse Practitioner | 2220 Vestal Pkwy E Fl 2, Vestal, NY 13850-1947 | 2019-06-21 |
| Find all providers in VESTAL | ||||
Please comment or provide details below to improve the information on MR. KEVIN ALAN WALL.
| 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.