Provider Demographics
NPI:1215384573
Name:WALKER, CYNTHIA (APN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 DOW ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2486
Mailing Address - Country:US
Mailing Address - Phone:615-603-2272
Mailing Address - Fax:
Practice Address - Street 1:206 BURWASH AVE
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9510
Practice Address - Country:US
Practice Address - Phone:217-356-3400
Practice Address - Fax:217-866-0122
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014228363LP2300X
TN25693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care