Provider Demographics
NPI:1265189450
Name:WALKER, KEMMERLY ELIZABETH (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KEMMERLY
Middle Name:ELIZABETH
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 SAND RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-7748
Mailing Address - Country:US
Mailing Address - Phone:318-205-9655
Mailing Address - Fax:
Practice Address - Street 1:111 MAIN STREET
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:WA
Practice Address - Zip Code:98932
Practice Address - Country:US
Practice Address - Phone:509-317-2182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA222176363LP2300X
AR230698363LF0000X
WAAP61677738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care