Healthcare Provider Details

I. General information

NPI: 1417387127
Provider Name (Legal Business Name): LINA ELIZABETH WALKER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINA ELIZABETH GARCIA-HICHEZ

II. Dates (important events)

Enumeration Date: 11/15/2013
Last Update Date: 11/01/2024
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 W LOWER BUCKEYE RD
PHOENIX AZ
85009-6729
US

IV. Provider business mailing address

4743 N 21ST AVE
PHOENIX AZ
85015-3731
US

V. Phone/Fax

Practice location:
  • Phone: 602-876-0322
  • Fax:
Mailing address:
  • Phone: 570-269-6124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022002506
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26N011083600
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN603706
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: