Healthcare Provider Details

I. General information

NPI: 1164104238
Provider Name (Legal Business Name): ANNA WALKER MSN, APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 W RIVERSIDE DR STE 406
BURBANK CA
91505-5301
US

IV. Provider business mailing address

3808 W. RIVERSIDE DR SUITE 406
BURBANK CA
91505-4325
US

V. Phone/Fax

Practice location:
  • Phone: 310-765-9019
  • Fax: 310-765-9019
Mailing address:
  • Phone: 310-765-9019
  • Fax: 310-765-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026321
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95179772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: