Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kim Ellen Walecka I, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1053397414

Kim Ellen Walecka I, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Dartmouth, Massachusetts. Qualified in 2001, 25 years ago. Practices with Lifespan Physician Group of Massachusetts Inc, a 457-clinician group. Licensed in Massachusetts.

Years since qualifying
25
Licensed in
MA
In the registry since
2005
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

228 Old Westport Rd
Dartmouth, MA 02747-2353
Phone: (774) 202-5729
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 216893 (MA)

Record details

NPI number1053397414
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorYes
NPI enumeratedDecember 19, 2005
Last updated in NPPESOctober 12, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Lifespan Physician Group Of Massachusetts Inc — 457 clinicians
Accepts Medicare assignment Not indicated

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