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General NPI Number Information
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NPI Number | 1134554017
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Entity Type | Individual
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Provider Name | AMY LYNN WALKER PRSS
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Gender | Female
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 1718 W BROADWAY AVE
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City | SULPHUR
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State | OK
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Zip | 73086-4244
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Country | US
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Telephone | 580-622-6127
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Fax | 580-622-6137
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Provider Business Mailing Address
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Address Line | 603 S 2ND ST
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City | DAVIS
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State | OK
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Zip | 73030-3154
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Country | US
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Telephone | 580-247-8830
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Fax | 580-622-6137
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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