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

Mrs. Nancy Waller, PA

Individual provider Medical Physician Assistant · NPI 1093982647

Mrs. Nancy Waller, PA is a Medical Physician Assistant in Pueblo, Colorado. Practices as a sole proprietor. Licensed in Colorado.

Licensed in
CO
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1339 S Pueblo Blvd
Pueblo, CO 81005-1508
Phone: (719) 647-5831
Fax: (719) 647-5833
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 120 (CO)

Record details

NPI number1093982647
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 13, 2008
Last updated in NPPESMay 13, 2008

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