Healthcare Provider Details

I. General information

NPI: 1255255659
Provider Name (Legal Business Name): ANNELIES WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 CENTRE AVE
PITTSBURGH PA
15213-1504
US

IV. Provider business mailing address

4610 CENTRE AVE
PITTSBURGH PA
15213-1504
US

V. Phone/Fax

Practice location:
  • Phone: 412-683-8827
  • Fax:
Mailing address:
  • Phone: 412-683-8827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSPO36554
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: