Provider Demographics
NPI:1548157829
Name:WALTER, KOREY ELLEN (FNP)
Entity type:Individual
Prefix:
First Name:KOREY
Middle Name:ELLEN
Last Name:WALTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1623
Mailing Address - Country:US
Mailing Address - Phone:314-971-6083
Mailing Address - Fax:
Practice Address - Street 1:7520 W 160TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-8137
Practice Address - Country:US
Practice Address - Phone:913-871-8221
Practice Address - Fax:913-495-5456
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84477-081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily