Healthcare Provider Details

I. General information

NPI: 1588604409
Provider Name (Legal Business Name): LUCY D WALKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4355 HICKORY BLVD
GRANITE FALLS NC
28630-1992
US

IV. Provider business mailing address

PO BOX 3300
LENOIR NC
28645-3300
US

V. Phone/Fax

Practice location:
  • Phone: 828-396-7550
  • Fax: 828-396-7535
Mailing address:
  • Phone: 828-757-6521
  • Fax: 828-757-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200952
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: