Lisa Kebalo-Walker, APN
Nurse Practitioner, Primary Care in Lyons, NJ. Individual provider (NPI-1).
NPI number1689201337
StatusActive
Last updated in NPPESNov 28, 2022
Details
- NPI
- 1689201337
- Entity type
- Individual (NPI-1)
- Name
- Lisa Kebalo-Walker
- Credential
- APN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 24, 2020
- Certification date
- Nov 28, 2022
- Last updated
- Nov 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 26NJ01018400 | NJ | Yes |
| 163WX1500X | Registered Nurse, Ostomy Care | 26NR11264700 | NJ | |
| 261QV0200X | Clinic/Center, VA | 26NJ01018400 | NJ | |
| 163WW0000X | Registered Nurse, Wound Care | 26NR11264700 | NJ | |
| 163WC2100X | Registered Nurse, Continence Care | 26NR11264700 | NJ |
Practice location
151 Knollcroft RdLyons, NJ 07939-5001
Phone 732-259-6671
Mailing address
151 Knollcroft RdLyons, NJ 07939-5001
Phone 732-259-6671
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Primary Care Nurse Practitioner providers in Lyons, NJ
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.