Walla, Kelsi V
Walla, Kelsi V is an sole proprietor health care provider with primary practice located at 2211 Lomas Blvd Ne , Albuquerque NM 87106-2719. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Walla, Kelsi V can be contacted via phone (480) 751-9804.Contact Information
Primary practice address
2211 Lomas Blvd Ne
Albuquerque NM 87106-2719
Phone: (480) 751-9804
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA2018-0032 | New Mexico |
Profile Details
| NPI number | 1063904464 |
|---|---|
| LBN Legal business name | Walla, Kelsi V |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2018 |
| Last updated | Jul 5th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063904464 | NPPES |
| New Mexico | MEDICAID | PA2018-0032 |
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