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NPI Code Detail

MEDICARE: MRS. SANDRA IRENE WALKER APRN

MEDICARE: MRS. SANDRA IRENE WALKER APRN
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
1363L00000XNurse Practitioner3007507KY

General Provider Information

NPI Number : 1952664179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA IRENE WALKER APRN
Provider Business Mailing Address
First Line : PO BOX 950248
Second Line :
City : LOUISVILLE
State : KY
Zip : 40295-0248
Country : US
Telephone Number : 502-489-5730
Fax Number : 502-489-5753
Provider Business Practice Location Address
First Line : 6580 KENWOOD CROSSING RD
Second Line :
City : CRESTWOOD
State : KY
Zip : 40014-7614
Country : US
Telephone Number : 502-243-3161
Fax Number : 502-243-3164
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2012
Last Update Date : 01/26/2015

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