Healthcare Provider Details

I. General information

NPI: 1346506466
Provider Name (Legal Business Name): ANDREA A WALKER APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HEALTH WAY
LAKE PLACID FL
33852-4716
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 863-465-7010
  • Fax: 863-465-4223
Mailing address:
  • Phone: 778-563-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9279916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: