Healthcare Provider Details

I. General information

NPI: 1114650918
Provider Name (Legal Business Name): KERRY ANTHONY WALKER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9980 PARK MEADOWS DR STE 200
LONE TREE CO
80124-8406
US

IV. Provider business mailing address

9980 PARK MEADOWS DR STE 200
LONE TREE CO
80124-8406
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-1961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: