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General NPI Number Information
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NPI Number | 1861440596
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Entity Type | Individual
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Provider Name | REGINA E WALKER NP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 269 RIDGECREST CIRCLE SUITE 109
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City | CLAYTON
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State | GA
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Zip | 30525
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Country | US
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Telephone | 706-782-7040
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Fax | 706-782-3123
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Provider Business Mailing Address
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Address Line | 269 RIDGECREST CIR
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City | CLAYTON
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State | GA
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Zip | 30525-4109
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Country | US
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Telephone | 706-782-7090
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Fax | 706-782-3123
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 091762
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License Number State | GA
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