Provider Demographics
NPI:1437818358
Name:WALKER, NATASHA MARIE (RN-BSN, WHNP STUDENT)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN-BSN, WHNP STUDENT
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:MARIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN-BSN, WHNP STUDENT
Mailing Address - Street 1:9722 QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:KS
Mailing Address - Zip Code:66514-9207
Mailing Address - Country:US
Mailing Address - Phone:208-602-5581
Mailing Address - Fax:
Practice Address - Street 1:9722 QUARRY RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:KS
Practice Address - Zip Code:66514-9207
Practice Address - Country:US
Practice Address - Phone:208-602-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS147032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program