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General NPI Number Information
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NPI Number | 1265918734
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Entity Type | Individual
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Provider Name | AUNDRE MATTHEW WALKER NP
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Gender | Male
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 1676 SUNSET AVE
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City | UTICA
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State | NY
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Zip | 13502-5416
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Country | US
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Telephone | 315-624-5226
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 HART ST
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City | UTICA
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State | NY
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Zip | 13502-4505
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Country | US
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Telephone | 347-528-0183
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 343317
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License Number State | NY
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