Provider Demographics
NPI:1124783568
Name:WALKER, STEPHANIE ANN (APRN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 INDUSTRIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-7668
Mailing Address - Country:US
Mailing Address - Phone:850-290-8410
Mailing Address - Fax:866-574-6391
Practice Address - Street 1:45 INDUSTRIAL BLVD STE C
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-7668
Practice Address - Country:US
Practice Address - Phone:850-290-8410
Practice Address - Fax:866-574-6391
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015818363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care