Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F10190607 | GA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 1639796196 | GA |
NPI | 1639796196 |
---|---|
Provider Name | Emma Liegh Walker |
First Address | Albany, GA 31707-4201 |
Second Address | Bainbridge, GA 39819-7791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2020 |
Last Update Date | 22/09/2020 |