Healthcare Provider Details

I. General information

NPI: 1245967066
Provider Name (Legal Business Name): JOSHUA N WALKER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

15790 PAUL VEGA DR
HAMMOND LA
70403-1436
US

IV. Provider business mailing address

15790 PAUL VEGA DR
HAMMOND LA
70403-1436
US

V. Phone/Fax

Practice location:
  • Phone: 985-345-2700
  • Fax: 985-230-2072
Mailing address:
  • Phone: 985-345-2700
  • Fax: 985-230-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226884
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: