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General NPI Number Information
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NPI Number | 1912993015
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Entity Type | Individual
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Provider Name | DEBRA WALKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 419 S WASHINGTON ST SUITE 102
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City | CASPER
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State | WY
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Zip | 82601-2951
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Country | US
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Telephone | 307-577-4220
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Fax | 307-235-0931
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Provider Business Mailing Address
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Address Line | 111 S 5TH ST
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City | DOUGLAS
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State | WY
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Zip | 82633-2434
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Country | US
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Telephone | 307-358-2122
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Fax | 307-358-3432
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 146
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License Number State | WY
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