Provider Demographics
NPI:1033841036
Name:WALKER, HEATHER GROS (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:GROS
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6076 MAGNOLIA WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-9189
Mailing Address - Country:US
Mailing Address - Phone:318-347-6429
Mailing Address - Fax:
Practice Address - Street 1:103 HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:LA
Practice Address - Zip Code:71061-8663
Practice Address - Country:US
Practice Address - Phone:318-995-6504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily