MEDICARE: SHEALYNN WALKER MSN, RN, ACNP-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	363L00000X	Nurse Practitioner	AP140943	TX
2	363LA2100X	Acute Care Nurse Practitioner	AP140943	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	760807	OTHER	TX	TEXAS BOARD OF NURSING

General Provider Information

NPI Number	:	1497213458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEALYNN WALKER MSN, RN, ACNP-BC

Provider Business Mailing Address
First Line	:	3800 TANGLEWILDE ST APT 1004
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-5163
Country	:	US
Telephone Number	:	832-338-7432
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 TANGLEWILDE ST APT 1004
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-5163
Country	:	US
Telephone Number	:	832-338-7432
Fax Number	:

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

Provider Enumeration Date	:	03/08/2019
Last Update Date	:	07/16/2024

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