Healthcare Provider Details

I. General information

NPI: 1043682677
Provider Name (Legal Business Name): JANET WALKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6084 APPLE TREE DR STE 11
MEMPHIS TN
38115-0305
US

IV. Provider business mailing address

6084 APPLE TREE DR STE 11
MEMPHIS TN
38115-0305
US

V. Phone/Fax

Practice location:
  • Phone: 901-683-0024
  • Fax: 901-683-0086
Mailing address:
  • Phone: 901-922-5951
  • Fax: 901-922-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20437
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: