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NPI Code Detail

MEDICARE: SHAUNTAE WALKER APRN, FNP-BC

MEDICARE: SHAUNTAE WALKER APRN, FNP-BC
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
1363LF0000XFamily Nurse PractitionerRN214618GA

General Provider Information

NPI Number : 1568828325
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNTAE WALKER APRN, FNP-BC
Provider Business Mailing Address
First Line : 7757 SYLVANER LN
Second Line :
City : ATLANTA
State : GA
Zip : 30349-8142
Country : US
Telephone Number : 580-678-3434
Fax Number :
Provider Business Practice Location Address
First Line : 2429 MLK JR DR SW
Second Line :
City : ATLANTA
State : GA
Zip : 30311-1713
Country : US
Telephone Number : 404-691-3344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2016
Last Update Date : 07/21/2022

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