Provider Demographics
NPI:1245809060
Name:WALKER, MATTHEW GARRETT (DNP, CRNA)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:GARRETT
Last Name:WALKER
Suffix:
Gender:M
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 WINDRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-2692
Mailing Address - Country:US
Mailing Address - Phone:205-983-3406
Mailing Address - Fax:
Practice Address - Street 1:400 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3512
Practice Address - Country:US
Practice Address - Phone:334-277-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-172132163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse