Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 22563 | TN |
NPI | 1003340720 |
---|---|
Provider Name | Annie Walker |
First Address | Nashville, TN 37208-2219 |
Second Address | Hermitage, TN 37076-2053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2017 |
Last Update Date | 15/05/2020 |