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Individual
MRS. KATIE ANN WALKER
Active
Individual
MRS. KATIE ANN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6445
MA
363AM0700X
Medical Physician Assistant
PA6445
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110149517A
—
MA
Enumeration date
02/06/2018
Last updated
11/14/2020
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