Individual provider · Type 1 NPI

Kelly R. Walter

Nurse Practitioner · Decatur, IL

NPI number 1447196183 Active

Practice location

1770 E Lake Shore Dr Ste 105
Decatur, IL 62521-3800

Fax (833) 784-5326

Other practice locations

  • 4662 Dogwood Ct, Decatur, IL 62526-9326 · (217) 413-7519

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X209036734 (IL)

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 1447196183

Kelly R. Walter's National Provider Identifier is 1447196183, issued on Apr 27, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Decatur, IL. The record was last updated on Oct 16, 2026.