Individual
KATLYNN NICOLE WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12024 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8906
(228) 760-0743
Mailing address
12024 LAMEY BRIDGE RD, DIBERVILLE, MS 39540-8906
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
914812
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
914812
REGISTERED NURSE LICENSE NUMBER
—
Enumeration date
12/23/2020
Last updated
12/23/2020
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