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NPI Code Detail

MEDICARE: MISS KELLY JAN WALEWSKI PA

MEDICARE: MISS KELLY JAN WALEWSKI PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant0010-04326NC

General Provider Information

NPI Number : 1316087463
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KELLY JAN WALEWSKI PA
Provider Business Mailing Address
First Line : 7540 SILVER VIEW LN
Second Line :
City : RALEIGH
State : NC
Zip : 27613-1071
Country : US
Telephone Number : 631-748-2567
Fax Number :
Provider Business Practice Location Address
First Line : 10 DUKE MEDICINE CIR
Second Line :
City : DURHAM
State : NC
Zip : 27710-1000
Country : US
Telephone Number : 919-385-0081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 03/09/2026

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Directions to “ MISS KELLY JAN WALEWSKI PA” Practice Location

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