Healthcare Provider Details

I. General information

NPI: 1518230374
Provider Name (Legal Business Name): ASHLEY ANN WALKER PA, CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ANN WALKER PA

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 SHORE DR
VIRGINIA BEACH VA
23451-1498
US

IV. Provider business mailing address

2829 SHORE DR
VIRGINIA BEACH VA
23451-1498
US

V. Phone/Fax

Practice location:
  • Phone: 757-734-1000
  • Fax:
Mailing address:
  • Phone: 757-734-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008866
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0110008866
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: