Healthcare Provider Details

I. General information

NPI: 1518450394
Provider Name (Legal Business Name): CHARLES D WALKER DNP, CRNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 REVERE ST
EL PASO TX
79905-1633
US

IV. Provider business mailing address

320 RIO PINSAQUI CT
EL PASO TX
79932-3029
US

V. Phone/Fax

Practice location:
  • Phone: 915-782-5300
  • Fax:
Mailing address:
  • Phone: 251-599-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-108286
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: