Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MIA MCKENZIE WALTERS, PA-C
Active Sole ProprietorMIA MCKENZIE WALTERS, PA-C is a Physician Assistant healthcare provider located in GLEN CARBON, Illinois. NPI 1801687355 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · GLEN CARBON, IL
Registration Details
- NPI Number
- 1801687355
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 14, 2025 (1.2278380211216 yrs)
- Last Updated
- Nov 24, 2025
- License
-
2025038815 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1455 VILLAGE CIRCLE DRGLEN CARBON, IL, 620344321Browse IL providers · Browse ZIP 62034
- Phone
- 6184771810
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in GLEN CARBON, IL
| Name | Credential | NPI |
|---|---|---|
| NATALIE D MENOSSI | PA | 1912195447 |
| ALANA BOLLONE | PA | 1730926536 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.