Provider Demographics
NPI:1982899670
Name:WALKER, KELLY A (NP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:A
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:585 MAIN ST # 1
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885-4316
Mailing Address - Country:US
Mailing Address - Phone:401-903-9634
Mailing Address - Fax:401-223-6307
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-973-7328
Practice Address - Fax:508-973-7282
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RINPP 37174363LA2100X
MARN199952363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care