Provider Demographics
NPI:1588348106
Name:WALKER, LANA ELIZABETH (FNP)
Entity type:Individual
Prefix:MRS
First Name:LANA
Middle Name:ELIZABETH
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-3039
Mailing Address - Country:US
Mailing Address - Phone:810-664-3660
Mailing Address - Fax:
Practice Address - Street 1:1101 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3039
Practice Address - Country:US
Practice Address - Phone:810-664-3660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily