Provider Demographics
NPI:1831833185
Name:WALKER, DUSTIN ERIC
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:ERIC
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 VISTA DEL RANCHO PKWY APT 163
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-6342
Mailing Address - Country:US
Mailing Address - Phone:775-772-5767
Mailing Address - Fax:
Practice Address - Street 1:890 MILL ST STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1436
Practice Address - Country:US
Practice Address - Phone:775-688-5878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV56732Medicaid