Individual
DEBRA WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
419 S WASHINGTON ST, SUITE 102, CASPER, WY 82601-2951
(307) 577-4220
(307) 235-0931
Mailing address
111 S 5TH ST, DOUGLAS, WY 82633-2434
(307) 358-2122
(307) 358-3432
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
146
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311761
BLUE CROSS BLUE SHIELD
WY
Enumeration date
09/23/2005
Last updated
05/29/2018
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