Healthcare Provider Details

I. General information

NPI: 1043252364
Provider Name (Legal Business Name): GERALDINE LEE OLLILA-WALKER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21B NORTHBROOK DRIVE
FALMOUTH ME
04105
US

IV. Provider business mailing address

21B NORTHBROOK DRIVE
FALMOUTH ME
04105
US

V. Phone/Fax

Practice location:
  • Phone: 207-805-8920
  • Fax: 207-904-0501
Mailing address:
  • Phone: 207-805-8920
  • Fax: 207-904-0501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1468
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: