Provider Demographics
NPI:1245789718
Name:WALTER, RACHEL A (NP-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:WALTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:290 NE TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5696
Mailing Address - Country:US
Mailing Address - Phone:816-524-5522
Mailing Address - Fax:816-524-4798
Practice Address - Street 1:290 NE TUDOR RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-524-5522
Practice Address - Fax:816-524-4798
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-77377363LF0000X
MO2016035598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily