Individual
CHANTALLE J WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7051 HEATHCOTE VILLAGE WAY, GAINESVILLE, VA 20155-3196
(571) 248-0167
(571) 248-0173
Mailing address
7051 HEATHCOTE VILLAGE WAY, GAINESVILLE, VA 20155-3196
(571) 248-0167
(571) 248-0173
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005852
VA
363A00000X
Physician Assistant
022133
NY
363A00000X
Physician Assistant
PA031383
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110005852
PA LICENSE
VA
01
—
022133
PA LICENSE
NY
01
—
PA031383
PA LICENSE
DC
Enumeration date
09/07/2017
Last updated
02/23/2022
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