Provider Demographics
NPI:1215454178
Name:MAXWELL-WALKER, WILLIAM ALAN (APRN)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALAN
Last Name:MAXWELL-WALKER
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:ALAN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1601 N. CHURCH
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823
Mailing Address - Country:US
Mailing Address - Phone:479-641-2255
Mailing Address - Fax:479-641-1889
Practice Address - Street 1:511 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-3601
Practice Address - Country:US
Practice Address - Phone:479-223-5130
Practice Address - Fax:479-567-5342
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily