Provider Demographics
NPI:1164756128
Name:KIMMEY-WALKER, LISA LU (APRN, CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:LU
Last Name:KIMMEY-WALKER
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1002 E STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2579
Mailing Address - Country:US
Mailing Address - Phone:281-762-8383
Mailing Address - Fax:281-762-8355
Practice Address - Street 1:1002 E STADIUM DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2579
Practice Address - Country:US
Practice Address - Phone:281-762-8383
Practice Address - Fax:281-762-8355
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP106063363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics