Provider Demographics
NPI:1457860801
Name:WALKER, CLAIRE MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50641 WEEPING WILLOW RUN E
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8751
Mailing Address - Country:US
Mailing Address - Phone:630-408-6468
Mailing Address - Fax:
Practice Address - Street 1:50641 WEEPING WILLOW RUN E
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8751
Practice Address - Country:US
Practice Address - Phone:269-340-0686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704385581367A00000X
IN09000299A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN178420025OtherMEDICARE PTAN
IN236040246OtherMEDICARE PTAN
IN300007491Medicaid