Provider Demographics
NPI:1962917799
Name:WALKER-MARQUETTE, NICOLE KRISTINE (APRN, CNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KRISTINE
Last Name:WALKER-MARQUETTE
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 LAKE DR E
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9302
Practice Address - Country:US
Practice Address - Phone:952-993-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR169334-8363L00000X
MN390200000X
MN5684363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program