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General NPI Number Information
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NPI Number | 1942351192
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Entity Type | Individual
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Provider Name | SUSAN M WALKER NP C
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 830 WASHINGTON ST 3RD FLOOR SAMARITAN MEDICAL CENTER PMC
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City | WATERTOWN
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State | NY
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Zip | 13601-3211
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Country | US
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Telephone | 315-785-4313
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Fax | 315-779-5114
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Provider Business Mailing Address
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Address Line | 104 PADDOCK ST PO BOX 779
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City | WATERTOWN
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State | NY
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Zip | 13601-0779
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Country | US
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Telephone | 315-785-8509
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Fax | 315-779-5114
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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 | F3330871
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License Number State | NY
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