Shivani Walkosak

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

28217074A Issued in IN

Practice address

700 E Walnut St
Evansville, IN 47713-2561

Phone

(812) 990-5800

NPI assigned

Jun 24, 2019

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: shivani.walkosak@1067223548755972.direct.elationemr.com

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1659932309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E WALNUT ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132561",
            "telephone_number": "812-990-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKOSAK",
        "first_name": "SHIVANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "28217074A",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009427A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Walker
• Rebecca Jean Walker, RN
• Shandra Walker
• Victoria Walker, RN
• William Matthew Walker, DO
• Brittney Wallace
• Derek Wallace
• Destiny Wallace
• Paris Wallace
• Patricia G Wallace, CNS

• Gerontology Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.