Provider Demographics
NPI:1255433306
Name:WALTERS, SARAH A (GNP, CHPN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:WALTERS
Suffix:
Gender:F
Credentials:GNP, CHPN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:MCGINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9200 INDIAN CREEK PKWY
Mailing Address - Street 2:BLDG. 9, STE. 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2036
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:8700 N GREEN HILLS RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1910
Practice Address - Country:US
Practice Address - Phone:913-574-2520
Practice Address - Fax:913-574-2612
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45056363LG0600X
MO148809363LG0600X, 163W00000X
KS84437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1255433306Medicaid
KS200402280BMedicaid
MOMA3347031Medicare PIN
Q71709Medicare UPIN
KS200402280BMedicaid