Provider Demographics
NPI:1912650367
Name:WALKER, CHRISTOPHER GLYNN
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:GLYNN
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:PO BOX 80929
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-0929
Mailing Address - Country:US
Mailing Address - Phone:850-496-1175
Mailing Address - Fax:
Practice Address - Street 1:1902 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4223
Practice Address - Country:US
Practice Address - Phone:850-496-1175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator