DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KEIONA L WALLER APRN, FNP-BC

MEDICARE: KEIONA L WALLER APRN, FNP-BC
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
1363LF0000XFamily Nurse Practitioner71014575AIN
2208VP0014XInterventional Pain Medicine Physician71014575AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366215071
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEIONA L WALLER APRN, FNP-BC
Provider Business Mailing Address
First Line : 29943 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1299
Country : US
Telephone Number : 317-706-3415
Fax Number :
Provider Business Practice Location Address
First Line : 8805 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-2760
Country : US
Telephone Number : 317-706-7246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2023
Last Update Date : 02/19/2026

Similar Medicare Providers

1245854801 — JESSICA RIDGE NP
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-7246
Practice Fax: 317-706-3417
1528022514 — APRIL NODINE PA-C
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-7246
Practice Fax:
1447356704 — DR. JOCELYN L. BUSH M.D.
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-7246
Practice Fax: 317-706-3419
1225243892 — MICHAEL ROBERT DORWART MD
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-7246
Practice Fax: 317-706-3417
1780864926 — SHADELAND ANESTHESIA
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-3415
Practice Fax: 317-706-3419
1275874497 — MR. TED J WESTLUND PA
Practice Location Address:
8805 N MERIDIAN ST
INDIANAPOLIS, IN
46260-2760
Practice Phone: 317-706-7246
Practice Fax: 317-706-3419

Directions to “ KEIONA L WALLER APRN, FNP-BC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.