Provider Demographics
NPI:1730131640
Name:WALKER, DOUGLAS ROBERTS (CRNA, APRN)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:ROBERTS
Last Name:WALKER
Suffix:
Gender:M
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:HARWINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06791-2418
Mailing Address - Country:US
Mailing Address - Phone:860-485-0206
Mailing Address - Fax:
Practice Address - Street 1:540 LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06791-2106
Practice Address - Country:US
Practice Address - Phone:860-496-6580
Practice Address - Fax:860-489-5519
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037584367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered