Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0097254 | CO |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0097254 | CO |
NPI | 1083041602 |
---|---|
Provider Name | Susan Renee Walker |
First Address | Denver, CO 80218-1235 |
Second Address | Denver, CO 80218-1235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2013 |
Last Update Date | 23/10/2013 |