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MRS. NANCY WALLER PA
NPI 1093982647
Physician Assistant - Medical in Pueblo, CO

Active since May 13, 2008
1339 S PUEBLO BLVD, PUEBLO, CO 81005(719) 647-5831(719) 647-5833 Get Directions Write a Review

NPPES record last updated: May 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Nancy Waller Pa NPPES

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

MRS. NANCY WALLER PA (NPI 1093982647) is an individual medical provider in Pueblo, Colorado, licensed in Colorado (120) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1093982647
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. NANCY WALLERCredential: PA
Location Address1339 S PUEBLO BLVDPueblo, CO 81005-1508
Mailing Address1339 S Pueblo BlvdPueblo, CO 81005-1508 · (719) 647-5831 · Fax (719) 647-5833
Phone(719) 647-5831
Fax(719) 647-5833
Sole ProprietorYes
Enumeration DateMay 13, 2008
✔ NPI 1093982647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CO · 120
1339 S PUEBLO BLVD, Pueblo, CO 81005
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Other Providers at the Same Location NPPES 3

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

SALLY GONZALES-APODACA C.P.A.
Physician Assistant
1339 S PUEBLO BLVD
PUEBLO, CO 81005
Pueblo County (719) 564-9400
BOONE GUEST HOME
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
1339 S PUEBLO BLVD
PUEBLO, CO 81005
Pueblo County (719) 564-0163
DESTINY INCORPORATED
Day Training, Developmentally Disabled Services
1339 S PUEBLO BLVD
PUEBLO, CO 81005
Pueblo County (719) 564-0163

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nancy Waller's NPI number?

The NPI number for Nancy Waller is 1093982647. It was assigned to this individual provider in the NPPES registry on May 13, 2008.

Where is Nancy Waller located?

Nancy Waller practices at 1339 S Pueblo Blvd, Pueblo, CO 81005. The listed phone number is (719) 647-5831.

What is Nancy Waller's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Nancy Waller was last updated on May 13, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.