Provider Demographics
NPI:1114650918
Name:WALKER, KERRY ANTHONY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ANTHONY
Last Name:WALKER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13001 E 17TH PL RM Q20N4205
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2570
Mailing Address - Country:US
Mailing Address - Phone:303-724-3022
Mailing Address - Fax:
Practice Address - Street 1:13001 E 17TH PL RM Q20N4205
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2570
Practice Address - Country:US
Practice Address - Phone:303-724-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist