Healthcare Provider Details

I. General information

NPI: 1871674580
Provider Name (Legal Business Name): CHRISTINE JEAN WALKER RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13521 MANE CT
JUSTIN TX
76247-1110
US

IV. Provider business mailing address

13521 MANE CT
JUSTIN TX
76247-1110
US

V. Phone/Fax

Practice location:
  • Phone: 940-648-1293
  • Fax: 940-648-1293
Mailing address:
  • Phone: 940-648-1293
  • Fax: 940-648-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number686637
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: