Provider Demographics
NPI:1154591295
Name:WALKER, ALICIA D (NP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:D
Other - Last Name:KRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:11934 W BROAD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1100
Mailing Address - Country:US
Mailing Address - Phone:804-423-2100
Mailing Address - Fax:804-716-5057
Practice Address - Street 1:11934 W BROAD ST STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1100
Practice Address - Country:US
Practice Address - Phone:804-423-2100
Practice Address - Fax:804-716-5057
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06695OtherGROUP PTAN
VAC06778OtherGROUP PTAN
VAC06695OtherGROUP PTAN