MEDICARE: KOREY ELLEN WALTER FNP

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
1	363LF0000X	Family Nurse Practitioner	53-84477-081	KS

General Provider Information

NPI Number	:	1548157829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOREY ELLEN WALTER FNP

Provider Business Mailing Address
First Line	:	608 E 73RD ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1623
Country	:	US
Telephone Number	:	314-971-6083
Fax Number	:

Provider Business Practice Location Address
First Line	:	7520 W 160TH ST STE 100
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66085-8137
Country	:	US
Telephone Number	:	913-871-8221
Fax Number	:	913-495-5456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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