Healthcare Provider Details

I. General information

NPI: 1730730771
Provider Name (Legal Business Name): TAMARA SUE WALKER PNP, PMHNP, PMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMARA S WALKER PNP, PMHNP, PMHS

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 HILLTOP DR STE 103
ROCK SPRINGS WY
82901-5858
US

IV. Provider business mailing address

1208 HILLTOP DR STE 103
ROCK SPRINGS WY
82901-5858
US

V. Phone/Fax

Practice location:
  • Phone: 307-371-2427
  • Fax: 307-224-2128
Mailing address:
  • Phone: 307-212-6082
  • Fax: 307-224-2128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number44082
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number44082
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: