Healthcare Provider Details

I. General information

NPI: 1770621781
Provider Name (Legal Business Name): PATRICIA LYNN WALKER RD, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HUGGINS HOSPTIAL 240 SOUTH MAIN STREET
WOLFEBORO NH
03894
US

IV. Provider business mailing address

375 STONEHAM RD
WOLFEBORO NH
03894-4709
US

V. Phone/Fax

Practice location:
  • Phone: 603-569-7549
  • Fax:
Mailing address:
  • Phone: 603-569-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number174
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: