Provider Demographics
NPI:1144940776
Name:WALKER, AMBER DIANE (PMHNP - BC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:DIANE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PMHNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9221 E BASELINE RD STE 109-422
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-8376
Mailing Address - Country:US
Mailing Address - Phone:480-716-8114
Mailing Address - Fax:480-716-7010
Practice Address - Street 1:2135 E UNIVERSITY DR STE 116
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-8335
Practice Address - Country:US
Practice Address - Phone:480-716-8114
Practice Address - Fax:480-716-7010
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRNP279873363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health