Individual
HOLLY BANKS WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2869
(601) 815-9356
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2869
(601) 815-9356
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
901573
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07723078
—
MS
01
—
P01788178
RAILROAD MEDICARE
MS
Enumeration date
07/22/2016
Last updated
03/22/2017
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