Provider Demographics
NPI:1972731883
Name:WALKER, MARTY LEE (ARNP3267952)
Entity Type:Individual
Prefix:MRS
First Name:MARTY
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:ARNP3267952
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 VALPARAISO PKWY BLDG C
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:FL
Mailing Address - Zip Code:32580-1206
Mailing Address - Country:US
Mailing Address - Phone:850-389-3015
Mailing Address - Fax:850-389-3016
Practice Address - Street 1:444 VALPARAISO PKWY
Practice Address - Street 2:BLD C
Practice Address - City:VALPARAISO
Practice Address - State:FL
Practice Address - Zip Code:32580-1206
Practice Address - Country:US
Practice Address - Phone:850-682-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3267952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily