MEDICARE: MS. NICOLE MARIE WALKER MSW

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	101YS0200X	School Counselor

General Provider Information

NPI Number	:	1881619195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE MARIE WALKER MSW

Provider Business Mailing Address
First Line	:	6133 TOURS CT APT 122
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4621
Country	:	US
Telephone Number	:	317-227-4420
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 S LYNHURST DR STE 205
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-5100
Country	:	US
Telephone Number	:	317-247-8900
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/08/2007

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