Basic Information
Provider Information
NPI: 1790327526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALKER
FirstName: LINDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 497
Address2:  
City: AUGUSTA
State: AR
PostalCode: 720060497
CountryCode: US
TelephoneNumber: 8703472534
FaxNumber: 8703471235
Practice Location
Address1: 406 RODGERS DR
Address2:  
City: SEARCY
State: AR
PostalCode: 721437433
CountryCode: US
TelephoneNumber: 5012797979
FaxNumber: 5013053535
Other Information
ProviderEnumerationDate: 10/14/2019
LastUpdateDate: 10/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X122234ARY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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