Provider Demographics
NPI:1184622888
Name:WALKER, KATHERINE LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1707 COLE BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3220
Mailing Address - Country:US
Mailing Address - Phone:303-763-4900
Mailing Address - Fax:303-763-5495
Practice Address - Street 1:6800 79TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80503-0000
Practice Address - Country:US
Practice Address - Phone:720-494-7100
Practice Address - Fax:303-652-0518
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO40593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86286773Medicaid
CO521278Medicare ID - Type Unspecified
CO86286773Medicaid
811532Medicare PIN