Provider Demographics
NPI:1477074003
Name:WALKER, KELLY (DNP, FNP)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8684
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59904-1684
Mailing Address - Country:US
Mailing Address - Phone:406-200-8564
Mailing Address - Fax:406-283-4023
Practice Address - Street 1:110 2ND ST E
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-200-8564
Practice Address - Fax:406-283-4023
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT126136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily