Provider Demographics
NPI:1356093017
Name:WALKER, CASEY (PMHNP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-773-4426
Practice Address - Street 1:200 HOLLY LN
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1670
Practice Address - Country:US
Practice Address - Phone:740-794-6019
Practice Address - Fax:740-794-6022
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.00306042084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0479741Medicaid
OHAPRN.CNP.0030604OtherSTATE LICENSURE