Individual provider · Type 1 NPI

Kayla Rene Vanderwall, PA-C

Surgical Physician Assistant · Indianapolis, IN

NPI number 1164840922 Active · reactivated Nov 19, 2019

Practice location

7430 N Shadeland Ave Ste 200
Indianapolis, IN 46250-2036

Call (317) 621-0668 Map

Mailing address

6626 E 75th St Ste 500
Indianapolis, IN 46250-2890

Other practice locations

  • 231 Noordewier Hall, Grand Rapids, MI 49546-4417 · (219) 743-9368
  • 1200 S York St Ste 3280, Elmhurst, IL 60126-5638 · (630) 646-6020
  • 7979 N Shadeland Ave Ste 310, Indianapolis, IN 46250-2042 · (317) 621-0668

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X085007328 (IL)
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

4 other providers at this address

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About NPI 1164840922

Kayla Rene Vanderwall, PA-C's National Provider Identifier is 1164840922, issued on Mar 30, 2014. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Indianapolis, IN. The record was last updated on Sep 1, 2022.