Provider Demographics
NPI:1841374089
Name:WALKER, JAMES A (CRNA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 E LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-8601
Mailing Address - Country:US
Mailing Address - Phone:859-313-2758
Mailing Address - Fax:
Practice Address - Street 1:1001 SAINT JOSEPH LN
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-8345
Practice Address - Country:US
Practice Address - Phone:606-330-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN8871367500000X
KY3000698367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3087447OtherBLUE CROSS BLUE SHIELD
TN430052521OtherRR MEDICARE
TN3626829Medicaid
TN4333863OtherBCBS UCAA
TN103I438786Medicare PIN
TN4333863OtherBCBS UCAA