Healthcare Provider Details

I. General information

NPI: 1245400100
Provider Name (Legal Business Name): BRANDI ADELE WALKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HENRY CLAY AVE
NEW ORLEANS LA
70118-5720
US

IV. Provider business mailing address

5 GLENWOOD AVE
HARAHAN LA
70123-4610
US

V. Phone/Fax

Practice location:
  • Phone: 504-894-6783
  • Fax:
Mailing address:
  • Phone: 504-919-7073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.201211
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD.201211
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: