Provider Demographics
NPI:1831652239
Name:WALKER, BOBBIE JO (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:JO
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:JO
Other - Last Name:LEATHERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:BIG BEND
Mailing Address - State:WV
Mailing Address - Zip Code:26136-0029
Mailing Address - Country:US
Mailing Address - Phone:740-277-9026
Mailing Address - Fax:
Practice Address - Street 1:622 MAZE RD
Practice Address - Street 2:
Practice Address - City:MUNDAY
Practice Address - State:WV
Practice Address - Zip Code:26152-8041
Practice Address - Country:US
Practice Address - Phone:740-277-9026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVF03190186363LF0000X
WV78385163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily