Provider Demographics
NPI:1568144053
Name:WALKER, MIKAYLA ANNE (NP)
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:ANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:3874 LEWIS LN
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6850
Mailing Address - Country:US
Mailing Address - Phone:270-929-4345
Mailing Address - Fax:
Practice Address - Street 1:12910 SHELBYVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-2404
Practice Address - Country:US
Practice Address - Phone:248-528-2116
Practice Address - Fax:502-996-8282
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY4006546363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health