Provider Demographics
NPI:1245568286
Name:WALKER, LORI L (CNP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 GIRARD BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1823
Mailing Address - Country:US
Mailing Address - Phone:505-266-3835
Mailing Address - Fax:505-266-3340
Practice Address - Street 1:1518 GIRARD BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1823
Practice Address - Country:US
Practice Address - Phone:505-266-3835
Practice Address - Fax:505-266-3340
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01540363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics