Provider Demographics
NPI:1194977348
Name:WALKER, ALISHA KRISTEN NICOLE (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:KRISTEN NICOLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:ALISHA
Other - Middle Name:KRISTEN NICOLE
Other - Last Name:MICHAELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2960 N CIRCLE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1163
Mailing Address - Country:US
Mailing Address - Phone:719-634-8891
Mailing Address - Fax:719-634-1897
Practice Address - Street 1:2960 N CIRCLE DR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1163
Practice Address - Country:US
Practice Address - Phone:719-634-8891
Practice Address - Fax:719-634-1897
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104765363A00000X
COPA0004583363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000493900Medicaid
FLAU176ZMedicare PIN
FLAU176YMedicare PIN
FLAU176XMedicare PIN