Provider Demographics
NPI:1508274267
Name:WALKER, STEPHANIE LYNN (NP-C)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WILKESBORO AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-4218
Mailing Address - Country:US
Mailing Address - Phone:336-990-0219
Mailing Address - Fax:336-990-0236
Practice Address - Street 1:114 WILKESBORO AVE
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4218
Practice Address - Country:US
Practice Address - Phone:336-990-0219
Practice Address - Fax:336-990-0236
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily