Ashley Tierra Waller, MSN, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN-NP286520 Issued in GA

Practice address

3633 Wheeler Rd Ste 365
Augusta, GA 30909-6549

Phone

(706) 432-6866

NPI assigned

Jul 2, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1033008180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W HAVEN DR",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310473122",
            "telephone_number": "478-508-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 WHEELER RD STE 365",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096549",
            "telephone_number": "706-432-6866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 E Nizhoni Blvd",
            "address_purpose": "LOCATION",
            "city": "Gallup",
            "state": "NM",
            "postal_code": "873015748",
            "country_code": "US",
            "telephone_number": "505-722-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ASHLEY",
        "middle_name": "TIERRA",
        "credential": "MSN, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP286520",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "GA",
            "license": "RN286520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Linton Wallace III, D.M.D.
• Takia Wallace
• Therrion Wallace
• Paul Wallach, MD
• John Joseph Wallbillich IV, M.D.
• Christian Waller
• Cynthia Sue Wallerich, MS, RD, LD
• Cynthia Thersa Walley, LAPC
• Shaquise Walls, RBT
• Regina Walsh, NP

• Psychiatric/Mental Health Nurse Practitioner in Augusta, GA
• Providers in Augusta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.