MEDICARE: MISS ANDRA M WALKER PA-C

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	363A00000X	Physician Assistant	1502328	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508041211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANDRA M WALKER PA-C

Provider Business Mailing Address
First Line	:	325 MAINE STREET
Second Line	:	MSO LIBRARY
City	:	LAWRENCE
State	:	KS
Zip	:	66044
Country	:	US
Telephone Number	:	785-505-2988
Fax Number	:

Provider Business Practice Location Address
First Line	:	6265 ROCK CHALK DR STE 1100
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66049-5232
Country	:	US
Telephone Number	:	785-842-5070
Fax Number	:	785-505-5264

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	10/25/2024

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