MEDICARE: MRS. KATHY HINMAN WALKER PHYSICIAN ASST

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	363A00000X	Physician Assistant	101680	NC

General Provider Information

NPI Number	:	1396746871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY HINMAN WALKER PHYSICIAN ASST

Provider Business Mailing Address
First Line	:	9869 OCEAN HWY W STE 10
Second Line	:
City	:	CALABASH
State	:	NC
Zip	:	28467-2636
Country	:	US
Telephone Number	:	910-755-6232
Fax Number	:	910-755-5984

Provider Business Practice Location Address
First Line	:	9869 OCEAN HWY W STE 10
Second Line	:
City	:	CALABASH
State	:	NC
Zip	:	28467
Country	:	US
Telephone Number	:	910-575-0281
Fax Number	:	910-550-3773

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	01/14/2019

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