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General NPI Number Information
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NPI Number | 1538833587
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Entity Type | Individual
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Provider Name | MRS. ANGELA SUE WALKER
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 8074 TALLIHO DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4813
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Country | US
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Telephone | 317-287-4003
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Fax | 888-335-0359
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Provider Business Mailing Address
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Address Line | 8074 TALLIHO DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4813
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Country | US
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Telephone | 317-287-4003
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Fax | 888-335-0359
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 27036491A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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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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