MEDICARE: DIANA E WALKER

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	332BC3200X	Customized Equipment (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies		NV

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

General Provider Information

NPI Number	:	1497196943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANA E WALKER

Provider Business Mailing Address
First Line	:	6420 SKY POINTE DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4052
Country	:	US
Telephone Number	:	702-778-9771
Fax Number	:	800-879-8138

Provider Business Practice Location Address
First Line	:	6420 SKY POINTE DR STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4052
Country	:	US
Telephone Number	:	702-778-9771
Fax Number	:	800-879-8138

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DIANA WALKER
Credential	:
Telephone Number	:	702-778-9771

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	12/30/2021

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Directions to “DIANA E WALKER ” Practice Location

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