Individual provider · Type 1 NPI
Mia McKenzie Walters, PA-C
Physician Assistant · Glen Carbon, IL
Practice location
1455 Village Circle Dr
Glen Carbon, IL 62034-4321
Mailing address
6420 Clayton Rd
St. Louis, MO 63117-1811
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant Primary | 363A00000X | 2025038815 (MO) |
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…
Other physician assistant providers in Glen Carbon
About NPI 1801687355
Mia McKenzie Walters, PA-C's National Provider Identifier is 1801687355, issued on May 14, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Glen Carbon, IL. The record was last updated on Nov 24, 2025.