Provider Demographics
NPI:1770756512
Name:WALKER, TWILLA MITCHELL (FNP)
Entity type:Individual
Prefix:
First Name:TWILLA
Middle Name:MITCHELL
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 FERN CREEK DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-9376
Mailing Address - Country:US
Mailing Address - Phone:704-878-2058
Mailing Address - Fax:704-872-6576
Practice Address - Street 1:1424 FERN CREEK DR
Practice Address - Street 2:SUITE D
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-9376
Practice Address - Country:US
Practice Address - Phone:704-878-2058
Practice Address - Fax:704-872-6576
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily