Healthcare Provider Details

I. General information

NPI: 1992351753
Provider Name (Legal Business Name): KRISTY LYNNE WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTINA LYNNE WALKER

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 WOODLAND HEIGHTS RD
LITTLE ROCK AR
72212-2495
US

IV. Provider business mailing address

6902 N HAVEN DR
ALEXANDER AR
72002-2884
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: