Individual
KIMBERLY GLENDORIA WALLEN
Active
Individual
KIMBERLY GLENDORIA WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1081405
ID
367500000X
Certified Registered Nurse Anesthetist
108532
KS
367500000X
Certified Registered Nurse Anesthetist
146248
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
2081405
ID
Other
Enumeration date
01/08/2016
Last updated
05/14/2026
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