MEDICARE: MRS. DORIS MARGUERITE WALKER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F331469	NY

General Provider Information

NPI Number	:	1053456046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DORIS MARGUERITE WALKER NP

Provider Business Mailing Address
First Line	:	23 BITTERSWEET LN
Second Line	:
City	:	SLINGERLANDS
State	:	NY
Zip	:	12159-9425
Country	:	US
Telephone Number	:	518-439-6354
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 WASHINGTON AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12222-0100
Country	:	US
Telephone Number	:	518-442-5306
Fax Number	:	518-442-5444

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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