Provider Demographics
NPI:1548850746
Name:WALKER, ANGELA M (CNM, APNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNM, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:720 S VANBUREN ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3504
Practice Address - Country:US
Practice Address - Phone:920-468-3444
Practice Address - Fax:920-432-6313
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI149017-32367A00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CNM06794OtherAMERICAN MIDWIFERY CERTIFICATION BOARD