Provider Demographics
NPI:1407106818
Name:WALKER, MEREDITH DIANNE (NP-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:DIANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 AARONWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2371
Mailing Address - Country:US
Mailing Address - Phone:330-830-8666
Mailing Address - Fax:
Practice Address - Street 1:2823 AARONWOOD AVE NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2371
Practice Address - Country:US
Practice Address - Phone:330-830-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.13852-NP363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care