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NPI Code Detail

MEDICARE: DAISY MAY WALKER PA-C

MEDICARE: DAISY MAY 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
1363A00000XPhysician Assistant3473TN

General Provider Information

NPI Number : 1730690371
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISY MAY WALKER PA-C
Provider Business Mailing Address
First Line : 1128 N CASTLE HEIGHTS AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087-5640
Country : US
Telephone Number : 423-352-4381
Fax Number : 423-352-4382
Provider Business Practice Location Address
First Line : 1128 N CASTLE HEIGHTS AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087-5640
Country : US
Telephone Number : 423-352-4381
Fax Number : 423-352-4382
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2017
Last Update Date : 11/14/2022

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Directions to “ DAISY MAY WALKER PA-C” Practice Location

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