Individual
STACY RAE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
61475 DUNCAN LN, BEND, OR 97702-2133
(360) 303-1944
Mailing address
61475 DUNCAN LN, BEND, OR 97702-2133
(360) 303-1944
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201601022RN
OR
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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