MEDICARE: ALEXIS 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	390200000X	Student in an Organized Health Care Education/Training Program		OK

General Provider Information

NPI Number	:	1760200026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS WALKER

Provider Business Mailing Address
First Line	:	2005 NW 28TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-1013
Country	:	US
Telephone Number	:	303-819-8856
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 NW 28TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-1013
Country	:	US
Telephone Number	:	303-819-8856
Fax Number	:

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

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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Directions to “ ALEXIS WALKER ” Practice Location

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