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General NPI Number Information
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NPI Number | 1497928840
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Entity Type | Individual
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Provider Name | JERAMIAH LOUIS WALKER APRN
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Gender | Male
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 100 NW 16TH ST
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City | NEWCASTLE
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State | OK
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Zip | 73065-6248
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Country | US
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Telephone | 405-387-3838
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Fax | 405-387-3822
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Provider Business Mailing Address
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Address Line | 300 NW 32ND ST
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City | NEWCASTLE
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State | OK
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Zip | 73065-6300
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Country | US
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Telephone | 405-387-3838
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Fax | 405-387-3822
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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 | R0073208
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License Number State | OK
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