Healthcare Provider Details

I. General information

NPI: 1689889792
Provider Name (Legal Business Name): COURTNYE A WALKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S FOUNTAIN DR
OLATHE KS
66061-7205
US

IV. Provider business mailing address

8300 SOMERSET DR
PRAIRIE VILLAGE KS
66207-1844
US

V. Phone/Fax

Practice location:
  • Phone: 913-712-7031
  • Fax:
Mailing address:
  • Phone: 843-324-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number04-45545
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberE-6383
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number2011038218
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number138793
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: