Provider Demographics
NPI:1467454553
Name:WALKER, DIANE WHITNEY (NP)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:WHITNEY
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:905 CEDAR CREEK GRADE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-7100
Mailing Address - Country:US
Mailing Address - Phone:540-723-0611
Mailing Address - Fax:540-723-9875
Practice Address - Street 1:905 CEDAR CREEK GRADE
Practice Address - Street 2:SUITE 101
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-7100
Practice Address - Country:US
Practice Address - Phone:540-723-0611
Practice Address - Fax:540-723-9875
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164255363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1467454553Medicaid
VA1467454553Medicaid
VA00X420R04Medicare PIN