Provider Demographics
NPI:1477831816
Name:WALKER, KATHRYN (APRN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 N HILLSIDE ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4923
Mailing Address - Country:US
Mailing Address - Phone:316-962-8587
Mailing Address - Fax:
Practice Address - Street 1:551 N HILLSIDE ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4923
Practice Address - Country:US
Practice Address - Phone:316-962-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-68463-072163WL0100X
KS53-74903-072364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant