Healthcare Provider Details

I. General information

NPI: 1760050413
Provider Name (Legal Business Name): ANGELINE G WALKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 SINTON RD STE 104
COLORADO SPRINGS CO
80907-5085
US

IV. Provider business mailing address

3720 SINTON RD STE 104
COLORADO SPRINGS CO
80907-5085
US

V. Phone/Fax

Practice location:
  • Phone: 719-493-9555
  • Fax:
Mailing address:
  • Phone: 719-493-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0996564-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRXN.0105646-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: