KEIRAN WALSH LLANEZA (NPI# 1396884219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396884219 |
| Entity Type | Individual |
| Full Name | KEIRAN WALSH LLANEZA |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
3125 Springbank Ln Suite E Charlotte NC 28226-3378 |
| Mailing Address |
Po Box 602148 Charlotte NC 28260-2148 |
| Practice Telephone | 7043813510 |
| Practice Fax Number | 7045403668 |
| Mailing Telephone | 7043813510 |
| Mailing Fax Number | 7045403668 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2014-04-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-00392 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
100392 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8102249 | 05 | |
| NC | 1396884219 | 05 | |
| SC | 0531PA | 05 |
| Street Address |
3125 SPRINGBANK LN SUITE E |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-3378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003895954 | Jay Berry Levy | Specialist | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3378 | 2006-01-10 |
| 1740714427 | Latisha Denise Williams | Health Educator | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3378 | 2017-04-19 |
| 1871713859 | Joseph A. Molitierno Jr. | Urology | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3379 | 2007-05-01 |
| 1952434672 | Carolinas Physicians Network, Inc. | Urology | 3125 Springbank Ln, Suite E, Charlotte, NC 28226-3378 | 2007-03-13 |
| 1265533095 | Lowell Harley Gill | Orthopaedic Surgery | 3125 Springbank Ln, Charlotte, NC 28226-3378 | 2006-09-26 |
| 1629019088 | Arboretum Obstetrics & Gynecology | Specialist | 3125 Springbank Ln, Suite B, Charlotte, NC 28226-3345 | 2006-06-09 |
| 1700865011 | Sophia Lorraine Paige | Obstetrics & Gynecology | 3125 Springbank Ln, Suite B, Charlotte, NC 28226-3345 | 2006-01-13 |
| 1972582286 | Mala Adele Freeman-kwaku | Obstetrics & Gynecology | 3125 Springbank Ln, Suite B, Charlotte, NC 28226-3345 | 2006-01-13 |
| 1497734701 | Octavia Manetta Cannon | Specialist | 3125 Springbank Ln, Suite B, Charlotte, NC 28226-3345 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1417506791 | Lauren Moir | Physician Assistant | 2700 Coltsgate Rd Ste 106, Charlotte, NC 28211-3573 | 2019-09-09 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1285172981 | Melanie Reyer | Physician Assistant | 5005 Morrowick Rd, Charlotte, NC 28226-7366 | 2017-02-02 |
| 1255877627 | Taylor King | Physician Assistant | 730 Hawthorne Ln Apt 443, Charlotte, NC 28204-2182 | 2017-01-10 |
| 1831579242 | Lindsey Chaney Taylor | Physician Assistant | 1900 Randolph Road, Suite 900, Charlotte, NC 28207-1122 | 2015-06-02 |
| 1306232079 | Rebecca Lee Strunk-lail | Physician Assistant | 1211 N. Community House Rd, Charlotte, NC 28277 | 2015-04-09 |
| 1194117432 | Harlee Palmer | Physician Assistant | 10502 Park Rd Suite 100, Charlotte, NC 28210-8479 | 2015-02-24 |
| 1154669364 | Laura A Justen | Physician Assistant | 1025 Morehead Medical Dr Ste 225, Charlotte, NC 28204-2974 | 2013-01-23 |
| Find all providers in CHARLOTTE | ||||
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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.