Provider Demographics
NPI:1043863418
Name:WALKER, DEBBIE LEE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:LEE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:835 MCKAY CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5786
Mailing Address - Country:US
Mailing Address - Phone:330-729-8970
Mailing Address - Fax:330-729-8971
Practice Address - Street 1:835 MCKAY CT STE 100
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5786
Practice Address - Country:US
Practice Address - Phone:330-729-8970
Practice Address - Fax:330-729-8971
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025108207Q00000X, 363LF0000X
PASP020630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0411459Medicaid