Provider Demographics
NPI:1356650089
Name:WALKER, MANEESHA ANN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MANEESHA
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8150 PERRY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5200
Mailing Address - Country:US
Mailing Address - Phone:412-369-9550
Mailing Address - Fax:412-369-9566
Practice Address - Street 1:1140 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2160
Practice Address - Country:US
Practice Address - Phone:412-364-4402
Practice Address - Fax:412-364-3850
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA054551363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103365429-0001Medicaid
PA103365429-0002Medicaid