Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 28174161A | IN |
NPI | 1013268739 |
---|---|
Provider Name | Cara E Walker |
First Address | Fort Wayne, IN 46804-3947 |
Second Address | Fort Wayne, IN 46845-1707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 23/03/2014 |