Individual provider · Type 1 NPI

Richard Keith Waller, APRN

Nurse Practitioner · Edgewood, KY

NPI number 1215770516 Active

Practice location

1 Medical Village Drive
Edgewood, KY 41017-3403

Other practice locations

  • 11135 Montgomery Rd, Cincinnati, OH 45249-2338 · (513) 791-7572

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000X0036149 (OH)
Nurse Practitioner Primary 363L00000X4047540 (KY)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1215770516

Richard Keith Waller, APRN's National Provider Identifier is 1215770516, issued on Jun 14, 2024. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Edgewood, KY. The record was last updated on Dec 15, 2025.