MEDICARE: CODY WALKER FNP-BC

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	1211383	TX

General Provider Information

NPI Number	:	1063391480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY WALKER FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 516
Second Line	:
City	:	OREGON
State	:	IL
Zip	:	61061-0516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 COLLIN MCKINNEY PKWY STE 302
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5109
Country	:	US
Telephone Number	:	214-272-2774
Fax Number	:

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

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	08/29/2025

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Directions to “ CODY WALKER FNP-BC” Practice Location

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