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Individual

CATHY S WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
1234 E. DUPONT RD., SUITE 6, FORT WAYNE, IN 46825-1545
(260) 480-2600
(260) 496-8077
Mailing address
1234 E. DUPONT RD., SUITE 6, FORT WAYNE, IN 46825-1545
(260) 480-2600
(260) 496-8077

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000608A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000549119
ANTHEM
IN
05
200287230
IN
Enumeration date
08/08/2006
Last updated
01/26/2010
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