Individual
BROCK D WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
Mailing address
2103 HERSHEY RD, ERIE, PA 16509-4515
(208) 221-8221
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28258298A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28258298A
NURSING LICENSE
IN
01
—
742947-1
NURSING LICENSE
NY
01
—
N-45784
NURSING LICENSE
ID
01
—
RN702670
NURSING LICENSE
PA
Enumeration date
04/07/2020
Last updated
04/07/2020
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