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NPI Code Detail

MEDICARE: MS. KAREN WALKER

MEDICARE: MS. KAREN 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
1103TC2200XClinical Child & Adolescent PsychologistNV

General Provider Information

NPI Number : 1679873996
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN WALKER
Provider Business Mailing Address
First Line : 4017 FABULOUS FINCHES AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-4808
Country : US
Telephone Number : 702-716-8673
Fax Number :
Provider Business Practice Location Address
First Line : 3624 RUSSIAN OLIVE ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-7643
Country : US
Telephone Number : 702-716-8673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2010
Last Update Date : 11/03/2010

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