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General NPI Number Information
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NPI Number | 1295763316
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Entity Type | Individual
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Provider Name | HOLLY DAWN WALKER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 1508 TOMBRAS AVE
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City | EAST RIDGE
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State | TN
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Zip | 37412-2720
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Country | US
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Telephone | 423-867-4969
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Fax | 423-867-4971
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Provider Business Mailing Address
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Address Line | 3024 BUSINESS PARK CIR
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3132
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Country | US
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Telephone | 615-239-2018
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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 | 12013
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License Number State | TN
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