Provider Demographics
NPI:1548225824
Name:WALKER, DOROTHY F (FNP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:F
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 1:4061 HIGHWAY PP
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3967
Mailing Address - Country:US
Mailing Address - Phone:573-778-0020
Mailing Address - Fax:573-778-1647
Practice Address - Street 1:2002 KANELL BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-4045
Practice Address - Country:US
Practice Address - Phone:573-727-9130
Practice Address - Fax:573-727-9128
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO083536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily