Provider Demographics
NPI:1003917485
Name:WALKER, LORRI LYNN (RNC, NP, CNM)
Entity Type:Individual
Prefix:
First Name:LORRI
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:RNC, NP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 BARRANCA PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4733
Mailing Address - Country:US
Mailing Address - Phone:949-654-2727
Mailing Address - Fax:
Practice Address - Street 1:4650 BARRANCA PKWY
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4733
Practice Address - Country:US
Practice Address - Phone:949-654-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANMW1212367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW012120Medicaid