MEDICARE: MRS. MADISON BROOKE WALKER APRN-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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0039599	OH

General Provider Information

NPI Number	:	1497407001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MADISON BROOKE WALKER APRN-CNP

Provider Business Mailing Address
First Line	:	22442 STATE ROUTE 73
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-6365
Country	:	US
Telephone Number	:	740-858-6656
Fax Number	:

Provider Business Practice Location Address
First Line	:	22442 STATE ROUTE 73
Second Line	:
City	:	WEST PORTSMOUTH
State	:	OH
Zip	:	45663-6365
Country	:	US
Telephone Number	:	740-858-6656
Fax Number	:	740-858-5412

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

Provider Enumeration Date	:	01/25/2022
Last Update Date	:	04/13/2026

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