Kimberly Glendoria Wallen, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2081405 Issued in ID

Practice address

3334 Monida St
Bozeman, MT 59718-8648

Phone

(804) 647-1635

NPI assigned

Jan 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kimberly Glendoria Leigh Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT, MN, ID3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cuyuna Regional Medical CenterGroup PAC ID 9537146550, shared by 3 NPIs, 133 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cuyuna Regional Medical Center Hospital, Crosby, MN, CCN 241353

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anesthesia Consulting Partners PLLC

  • Anesthesiology Physician
  • Butte, MT
  • NPI 1053092189
  Medicare reassignment NPD
• Diamond Anesthesia, PC

  • Certified Registered Nurse Anesthetist
  • Billings, MT
  • NPI 1912553280

  Anesthesiology

  Medicare reassignment NPD
• Powell County Memorial Hospital Association Inc

  • Family Medicine Physician
  • Deer Lodge, MT
  • NPI 1841414026
  Medicare reassignment NPD
• Aitkin Community Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Aitkin, MN
  • NPI 1174687040
  Medicare reassignment NPD
• Aitkin Community Hospital, Inc.

  • Critical Access Hospital
  • Aitkin, MN
  • NPI 1942277835
  Medicare reassignment NPD
• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Medicare reassignment NPD
• Cuyuna Regional Medical Center

  • Family Medicine Physician
  • Longville, MN
  • NPI 1861414518
  Medicare reassignment NPD
• Lakewood Health System

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment NPD
• Anesthesia Associates of Coeur D Alene PLLC

  • Anesthesiology Physician
  • Coeur D Alene, ID
  • NPI 1962440966
  Medicare reassignment
• Livingston Healthcare

  • Rehabilitation Clinic/Center
  • Gardiner, MT
  • NPI 1225670375
  NPD
• Livingston Healthcare

  • Critical Access Hospital
  • Livingston, MT
  • NPI 1245222306
  NPD
• Livingston Healthcare Urgent Care

  • Urgent Care Clinic/Center
  • Livingston, MT
  • NPI 1780077354
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Care Compare affiliation

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1033575907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 MONIDA ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597188648",
            "telephone_number": "804-647-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 MONIDA ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597188648",
            "telephone_number": "804-647-1635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Mt Highway 91 S",
            "address_purpose": "LOCATION",
            "city": "Dillon",
            "state": "MT",
            "postal_code": "597257379",
            "country_code": "US",
            "telephone_number": "406-683-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "KIMBERLY",
        "middle_name": "GLENDORIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-08",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "1081405",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "108532",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "2081405",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "146248",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwallen1163213@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LEIGH",
            "middle_name": "GLENDORIA",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrianne V Wallace, MFTLC
• Joshua Wallace, LMT
• Maureen V Wallace, MPT
• Richard M. Wallace, M.D.
• Steven Mark Wallace, L.M.T
• John L Waller, MD
• Christopher Ryan Wallis, D.D.S.
• Patricia Walls, NNP, MSN, RNC
• Walmart Inc.
• Walmart, Inc.

• Certified Registered Nurse Anesthetist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Certified Registered Nurse Anesthetist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.