Provider Demographics
NPI:1134681950
Name:WALKER, GABRIELLE ALLENA
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ALLENA
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 E SOUTH BLVD STE 806
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2007
Mailing Address - Country:US
Mailing Address - Phone:334-747-8920
Mailing Address - Fax:334-747-8930
Practice Address - Street 1:2055 E SOUTH BLVD STE 806
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2007
Practice Address - Country:US
Practice Address - Phone:334-747-8920
Practice Address - Fax:334-747-8930
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-164733363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner