Basic Information
| Provider Information | |||||||||
| NPI: | 1922631753 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | WALKER | ||||||||
| OtherFirstName: | EMILY | ||||||||
| OtherMiddleName: | RUTH | ||||||||
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| OtherCredential: | FNP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 131 DERBY SHIRE PL | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018154238 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1751 E GARRY AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927055814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778967350 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2020 | ||||||||
| LastUpdateDate: | 02/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 123343 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.