Provider Demographics
NPI:1164572079
Name:WALKER, TONYA RENEE (ANP)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:RENEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27260-2603
Mailing Address - Country:US
Mailing Address - Phone:336-454-6738
Mailing Address - Fax:336-334-5343
Practice Address - Street 1:107 GRAY DRIVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402-6170
Practice Address - Country:US
Practice Address - Phone:336-334-5340
Practice Address - Fax:336-334-5343
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC129200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health