Healthcare Provider Details

I. General information

NPI: 1922668896
Provider Name (Legal Business Name): ALISA WALKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 10/31/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1067 13TH ST SE
HICKORY NC
28602-2771
US

IV. Provider business mailing address

PO BOX 2123
BRYSON CITY NC
28713-5123
US

V. Phone/Fax

Practice location:
  • Phone: 910-663-2273
  • Fax: 910-663-4050
Mailing address:
  • Phone: 910-490-0490
  • Fax: 828-538-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011829
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011829
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: