Christa J Wall (NPI# 1588949762, PAC ID# 9537333844) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1588949762 |
PAC ID by PECOS | 9537333844 |
Professional Enrollment ID | I20111123000452 |
Full Name | Christa J Wall |
Organization Legal Name | ADVANCED CARE CONNECTIONS LLC |
Address |
3010 Independence Dr Fort Wayne IN 46808-1328 |
Phone Number | 2607395821 |
Gender | F |
Graduation Year | 2010 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 5799080511 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
150021 | PARKVIEW REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
3010 Independence Dr, Fort Wayne, IN 46808-1328 | 2607395821 | ADVANCED CARE CONNECTIONS LLC |
Organization Legal Name | ADVANCED CARE CONNECTIONS LLC |
Physicians | 4 |
Name | Specialty | Organization | Address |
---|---|---|---|
Linzie Howard | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Nikki Joy Mann | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Melissa Sue Ottenweller | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Street Address |
3010 INDEPENDENCE DR |
City | FORT WAYNE |
State | IN |
Zip | 46808-1328 |
Name | Specialty | Organization | Address |
---|---|---|---|
Linzie Howard | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Nikki Joy Mann | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Melissa Sue Ottenweller | Nurse Practitioner | Advanced Care Connections LLC | 3010 Independence Dr, Fort Wayne, IN 46808-1328 |
Name | Specialty | Organization | Address |
---|---|---|---|
Tammy L. Truijens | Psychologist, Clinical | The Otis R Bowen Center for Human Services Inc | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 |
Kelly Ann Baumgarden | Psychologist, Clinical | The Otis R Bowen Center for Human Services Inc | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 |
Scott J Mcalister | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 |
Amber Marie Butler | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 |
Rachel E Roberts | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 |
Danielle F Teel | Optometry | Teel Family Eye Care | 5110 Value Dr, Fort Wayne, IN 46808-4048 |
City | FORT WAYNE |
Zip Code | 46808 |
Specialty | NURSE PRACTITIONER |
City + Specialty | FORT WAYNE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Christa J Wall.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.