Annessa Faye Van de Walle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

618160 Issued in TX

Practice address

291 Harris Dr
Austin, TX 78737-4606

Phone

(817) 366-7542

NPI assigned

Apr 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Annessa Faye Green Former name

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.

• San Antonio a Thru Z Pediatrics PA

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1609931088
  NPD (past)

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1376800235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 HARRIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787374606",
            "telephone_number": "817-366-7542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 HARRIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787374606",
            "telephone_number": "817-366-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE WALLE",
        "first_name": "ANNESSA",
        "middle_name": "FAYE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "618160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNESSA",
            "last_name": "GREEN",
            "middle_name": "FAYE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Van Burkleo, SLPA
• Alexandra Bailey Van Cleave
• William C Van de Graaf, MD
• Grace Van de Hoef, SLP
• Jordan Michael Van de Vere, C. PED
• Zachary David Van Den Berg, LPC-ASSOCIATE, ATR-P
• Roxane Van Der Lelie, MFT-A
• Christian J. Van Der Schijff, PT, DPT, LAT, ATC
• Tarina Van Der Stockt
• Catherine Van Der Westhuizen, MA, LPC, LMFT

• Family Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.