Provider Demographics
NPI:1821270893
Name:WALKER, LAKENDRA (FNP)
Entity Type:Individual
Prefix:
First Name:LAKENDRA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:LAKENDRA
Other - Middle Name:
Other - Last Name:WALKER - HOGANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:777 CLEVELAND AVE SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7129
Mailing Address - Country:US
Mailing Address - Phone:404-755-2291
Mailing Address - Fax:
Practice Address - Street 1:1203 CLEVELAND AVE STE D
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30344-3417
Practice Address - Country:US
Practice Address - Phone:404-755-2291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA184336163W00000X
GARN184336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA184336OtherREGISTERED NURSE