Healthcare Provider Details

I. General information

NPI: 1255695946
Provider Name (Legal Business Name): BOSTELLA WALKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 ZEMKE AVE
TAMPA FL
33621-5023
US

IV. Provider business mailing address

3250 ZEMKE AVE
TAMPA FL
33621-5023
US

V. Phone/Fax

Practice location:
  • Phone: 813-827-9235
  • Fax:
Mailing address:
  • Phone: 813-827-9235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP 9306867
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN9306867
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: