Provider Demographics
NPI:1194770693
Name:WALKER, KIMBERLEE A (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:A
Last Name:WALKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S MARKET ST
Mailing Address - Street 2:P.O. BOX 458
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2924
Mailing Address - Country:US
Mailing Address - Phone:647-683-5773
Mailing Address - Fax:641-226-5759
Practice Address - Street 1:201 S MARKET ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2924
Practice Address - Country:US
Practice Address - Phone:647-683-5773
Practice Address - Fax:641-226-5759
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA070139363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42935OtherBLUE CROSS BLUE SHIELD
IA0221176Medicaid
IA42935OtherBLUE CROSS BLUE SHIELD
IA161813Medicare PIN
IA0221176Medicaid