Healthcare Provider Details

I. General information

NPI: 1861822330
Provider Name (Legal Business Name): ASHLEIGH S WALKER NURSE PRACTITONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SENECA ST STE 646C
BUFFALO NY
14210-1351
US

IV. Provider business mailing address

425 ESSJAY RD STE 170
WILLIAMSVILLE NY
14221-5782
US

V. Phone/Fax

Practice location:
  • Phone: 716-995-4450
  • Fax:
Mailing address:
  • Phone: 716-800-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number669894-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number669894-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number011635
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF342583-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number669894-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: