MEDICARE: CASSANDRA WALKER NP

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	363LF0000X	Family Nurse Practitioner	R212921	MD
2	363L00000X	Nurse Practitioner	0024187352	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366046682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA WALKER NP

Provider Business Mailing Address
First Line	:	253 KERCHNER RD
Second Line	:
City	:	WALKERSVILLE
State	:	MD
Zip	:	21793-8259
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	97 THOMAS JOHNSON DR STE 200
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-4374
Country	:	US
Telephone Number	:	240-547-6464
Fax Number	:

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

Provider Enumeration Date	:	11/27/2020
Last Update Date	:	01/15/2024

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Directions to “ CASSANDRA WALKER NP” Practice Location

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