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General NPI Number Information
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NPI Number | 1952052912
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Entity Type | Individual
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Provider Name | MELISSA ROSE WALKER CNP
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Gender | Female
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 200 ELM ST N
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City | ONAMIA
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State | MN
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Zip | 56359-7901
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Country | US
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Telephone | 320-532-3154
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Fax |
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Provider Business Mailing Address
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Address Line | 39439 TWILIGHT RD
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City | ONAMIA
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State | MN
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Zip | 56359-7928
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Country | US
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Telephone | 763-567-0081
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Fax |
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 8566
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License Number State | MN
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