Provider Demographics
NPI:1952664179
Name:WALKER, SANDRA IRENE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:IRENE
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-489-5730
Mailing Address - Fax:502-489-5753
Practice Address - Street 1:6580 KENWOOD CROSSING RD
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-7614
Practice Address - Country:US
Practice Address - Phone:502-243-3161
Practice Address - Fax:502-243-3164
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2015-01-26
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Provider Licenses
StateLicense IDTaxonomies
KY3007507363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner