Healthcare Provider Details

I. General information

NPI: 1962213769
Provider Name (Legal Business Name): HANNA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6130 TRIER RD
FORT WAYNE IN
46815-5378
US

IV. Provider business mailing address

6130 TRIER RD
FORT WAYNE IN
46815-5378
US

V. Phone/Fax

Practice location:
  • Phone: 260-203-0787
  • Fax:
Mailing address:
  • Phone: 260-203-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: