| Kelsey Danielle Walts, | |
|
3501 Knickerbocker Rd, San Angelo, TX 76904-7610 | |
| (325) 747-2285 | |
| (325) 747-4635 |
| Full Name | Kelsey Danielle Walts |
|---|---|
| Gender | Female |
| Speciality | Advanced Practice Midwife |
| Location | 3501 Knickerbocker Rd, San Angelo, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053036673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | 1096036 (Texas) | Primary |
| Entity Name | Shannon Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770587149 PECOS PAC ID: 0840103727 Enrollment ID: O20031222000702 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelsey Danielle Walts, Po Box 22000, San Angelo, TX 76902-7200 Ph: (325) 747-3408 | Kelsey Danielle Walts, 3501 Knickerbocker Rd, San Angelo, TX 76904-7610 Ph: (325) 747-2285 |
Mary-jo Urbano, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 120 E Harris Ave, San Angelo, TX 76903 Phone: 325-747-6741 | |
Cynthia Stokes, RN, MSN, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 1610 S Chadbourne St, San Angelo, TX 76903 Phone: 325-658-5339 Fax: 325-659-8534 | |
Christina Arp, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 220 E. Harris, San Angelo, TX 76903 Phone: 325-481-2285 Fax: 325-481-2056 | |
Opal L Smith, CNM Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 220 E. Harris, San Angelo, TX 76903 Phone: 325-658-1511 |