Provider Demographics
NPI:1437110855
Name:WALKER, CHRIST A (PA)
Entity Type:Individual
Prefix:
First Name:CHRIST
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 W LOOMIS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8030
Mailing Address - Country:US
Mailing Address - Phone:414-488-1111
Mailing Address - Fax:414-488-0700
Practice Address - Street 1:10500 W LOOMIS RD STE 120
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8030
Practice Address - Country:US
Practice Address - Phone:414-488-1111
Practice Address - Fax:414-488-0700
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI709-023363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42943400Medicaid
WI0003Medicare ID - Type Unspecified
WI42943400Medicaid