Provider Demographics
NPI:1114975000
Name:WALKER, PATRICIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1714
Mailing Address - Country:US
Mailing Address - Phone:781-784-0141
Mailing Address - Fax:781-784-0141
Practice Address - Street 1:19 HENRY ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1714
Practice Address - Country:US
Practice Address - Phone:339-364-1979
Practice Address - Fax:781-250-8488
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA184424163WG0000X, 163WG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0799343Medicaid
MAWA-NP5343Medicare ID - Type Unspecified
MA0799343Medicaid