Lisa Kebalo-Walker, APN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ01018400 Issued in NJ

Practice address

151 Knollcroft Rd
Lyons, NJ 07939-5001

Phone

(732) 259-6671

NPI assigned

Mar 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1689201337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "732-259-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KNOLLCROFT RD",
            "city": "LYONS",
            "state": "NJ",
            "postal_code": "079395001",
            "telephone_number": "732-259-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBALO-WALKER",
        "first_name": "LISA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "NJ",
            "license": "26NR11264700",
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NJ",
            "license": "26NJ01018400",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01018400",
            "primary": true
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "NJ",
            "license": "26NR11264700",
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "NJ",
            "license": "26NR11264700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Donald Jackson
• Genevia T Jones, LCSW
• Jeffrin M Joseph, LSW
• Maureen Kaune, M.D.
• Michelle Kawecki, D.AC.
• Tami Kim, DMD
• Arlene R King, PH.D.
• Vanjai Kitcharoen, M.D.
• Steven A Klapper, OTR
• Rachel Ann Kloos, LCSW

• Primary Care Nurse Practitioner in Lyons, NJ
• Providers in Lyons, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.