Provider Demographics
NPI:1992944268
Name:WALKER, DANIS A (PA)
Entity type:Individual
Prefix:MS
First Name:DANIS
Middle Name:A
Last Name:WALKER
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:DANIS
Other - Middle Name:A
Other - Last Name:IKNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1631 ELYSIAN FIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-8208
Mailing Address - Country:US
Mailing Address - Phone:504-821-2601
Mailing Address - Fax:888-736-9806
Practice Address - Street 1:2515 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6435
Practice Address - Country:US
Practice Address - Phone:504-821-2601
Practice Address - Fax:888-736-9806
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002935363AM0700X, 363AM0700X
LAPA.200540363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3011761Medicaid
LA2396463Medicaid
CAMW1940332OtherDEA
OH9304251Medicare PIN
CAMW1940332OtherDEA