MS. SANDRA D WALLER FNP, MSN
NPI 1043260441
Nurse Practitioner in Memphis, TN

Q: What is Sandra Waller's NPI number?

The NPI number for Sandra Waller is 1043260441. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Q: What is Sandra Waller's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Sandra Waller was last updated on June 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 10, 2006

2861 BROAD AVE, MEMPHIS, TN 38112(901) 260-8500(901) 325-6469 Get Directions Write a Review

NPPES record last updated: June 6, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ms. Sandra D Waller Fnp, Msn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SANDRA D WALLER FNP, MSN (NPI 1043260441) is an individual nurse practitioner in Memphis, Tennessee, licensed in Tennessee (APN0000005098) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1043260441

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMS. SANDRA D WALLERCredential: FNP, MSN

Location Address2861 BROAD AVEMemphis, TN 38112-2903

Mailing Address2595 Central AveMemphis, TN 38104-5905 · (901) 260-8551 · Fax (901) 260-8590

Phone(901) 260-8500

Fax(901) 325-6469

Sole ProprietorNo

Enumeration DateMay 10, 2006

Last NPPES UpdateJune 6, 2012

✔ NPI 1043260441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in TN · APN0000005098

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2861 BROAD AVE, Memphis, TN 38112

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Other Identifiers 3

Medicare PIN3346145TN

Medicare UPINS56025TN

Medicaid3346145TN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREW BUCHMAN NEARN M.D.

Pediatrics