Provider Demographics
NPI:1063850477
Name:WALKER, PAULA LENORE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:LENORE
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WOODBRIDGE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SOMERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38068
Mailing Address - Country:US
Mailing Address - Phone:901-465-6353
Mailing Address - Fax:901-465-5948
Practice Address - Street 1:25 WOODBRIDGE
Practice Address - Street 2:SUITE A
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068
Practice Address - Country:US
Practice Address - Phone:901-465-6353
Practice Address - Fax:901-465-5948
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily