Provider Demographics
NPI:1386737054
Name:WALKER, JULIE P (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:P
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 25TH STREET
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311
Mailing Address - Country:US
Mailing Address - Phone:423-479-9733
Mailing Address - Fax:423-472-1890
Practice Address - Street 1:435 25TH STREET
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311
Practice Address - Country:US
Practice Address - Phone:423-479-9733
Practice Address - Fax:423-472-1890
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7435363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3344202Medicaid
TN3381759Medicaid