Provider Demographics
NPI:1285226340
Name:WALKER, ANDREA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-3114
Mailing Address - Country:US
Mailing Address - Phone:918-748-7500
Mailing Address - Fax:918-921-7706
Practice Address - Street 1:1205 W MAIN ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021-3114
Practice Address - Country:US
Practice Address - Phone:918-387-0440
Practice Address - Fax:918-921-7706
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK116016163W00000X
OK207888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse