Healthcare Provider Details

I. General information

NPI: 1265666242
Provider Name (Legal Business Name): KATHRYN WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 06/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE ST ONE CHILDREN'S HOSPITAL DRIVE
OMAHA NE
68114-4113
US

IV. Provider business mailing address

8200 DODGE ST ONE CHILDREN'S HOSPITAL DRIVE
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-4353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number29251
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: