=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295425106
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JULENE WALKER NP IN FAMILY HEALTH PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/12/2023
-----------------------------------------------------
Last Update Date | 10/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24912 JERICHO TPKE STE 200
-----------------------------------------------------
City | FLORAL PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11001-4021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-813-0484
-----------------------------------------------------
Fax | 516-203-1123
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 82 ROCKAWAY AVE
-----------------------------------------------------
City | VALLEY STREAM
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11580-5811
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. JULENE WALKER
-----------------------------------------------------
Credential | DNP, FNP-C
-----------------------------------------------------
Telephone | 718-813-0484
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------