Individual provider · Type 1 NPI

Deven Waller

Physician Assistant · Albuquerque, NM

NPI number 1750165205 Active

Practice location

1500 N Renaissance Blvd NE Ste C
Albuquerque, NM 87107-7002

Call (505) 266-5565 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1750165205

Deven Waller's National Provider Identifier is 1750165205, issued on Aug 23, 2023. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Albuquerque, NM. The record was last updated on Sep 3, 2025.