MEDICARE: LORI L WALKER CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	CNP-01540	NM

General Provider Information

NPI Number	:	1245568286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI L WALKER CNP

Provider Business Mailing Address
First Line	:	1518 GIRARD BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-1823
Country	:	US
Telephone Number	:	505-266-3835
Fax Number	:	505-266-3340

Provider Business Practice Location Address
First Line	:	1518 GIRARD BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-1823
Country	:	US
Telephone Number	:	505-266-3835
Fax Number	:	505-266-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	03/23/2016

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