Basic Information
| Provider Information | |||||||||
| NPI: | 1013912971 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | SHEILA | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3433 NW 56TH STREET | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059473341 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3433 NW 56TH STREET | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059473341 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 09/19/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 655 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.