Provider Demographics
NPI:1336797018
Name:WALKER, REBECCA (RN, BSN, FNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN, BSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:IA
Mailing Address - Zip Code:51030-0053
Mailing Address - Country:US
Mailing Address - Phone:712-389-2089
Mailing Address - Fax:
Practice Address - Street 1:814 PIERCE ST STE 300
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1058
Practice Address - Country:US
Practice Address - Phone:712-226-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA130143163WX0106X
IAA167411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health