Provider Demographics
NPI:1912340902
Name:WALKER, LISA RACHEL (NP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RACHEL
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:6275 E VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2851
Mailing Address - Country:US
Mailing Address - Phone:757-461-3141
Mailing Address - Fax:757-461-1658
Practice Address - Street 1:6275 E VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2851
Practice Address - Country:US
Practice Address - Phone:757-461-3141
Practice Address - Fax:757-461-1658
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024170541363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner