Provider Demographics
NPI:1598288730
Name:WALKER, MICHELLE (CNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 WEEKS RD
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:MI
Mailing Address - Zip Code:49246-9544
Mailing Address - Country:US
Mailing Address - Phone:517-205-7690
Mailing Address - Fax:
Practice Address - Street 1:8713 WEEKS RD
Practice Address - Street 2:
Practice Address - City:HORTON
Practice Address - State:MI
Practice Address - Zip Code:49246
Practice Address - Country:US
Practice Address - Phone:517-250-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704212692363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner