Kevin Wanga, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP016803 Issued in PA

Practice address

2500 Lisburn Rd
Camp Hill, PA 17011-8005

Phone

(717) 737-4531

Fax

(717) 731-1007

NPI assigned

Mar 11, 2014

Sex

Male

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

State licenses

Practice roles

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.

• Heritage Medical Group, LLP

  • Family Medicine Physician
  • Highspire, PA
  • NPI 1831494798
  NPD (past)

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1184040487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 HEATHERTON DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176013979",
            "telephone_number": "717-341-7645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LISBURN RD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170118005",
            "telephone_number": "717-737-4531",
            "fax_number": "717-731-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANGA",
        "first_name": "KEVIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-11",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN653205",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP016803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Rae Walsh
• Jenna Lynne Walswick
• Thomas Carl Walter, MPA-C, DPT
• Andrea Rae Walters, PHARMD
• Michael Paul Waltz, D.M.D.
• Ann Marie Waris, RN
• Danuta Frances Warner, RN
• Amanda Lyn Warriner, RN
• Kristy Lynn Washinger, CRNP
• Tara Wasserman, RN

• All providers in Camp Hill, PA
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.