Provider Demographics
NPI:1730385550
Name:NANCY BRILEY WALKER, M.D., A.P.M. L.L.C.
Entity type:Organization
Organization Name:NANCY BRILEY WALKER, M.D., A.P.M. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:BRILEY
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-783-4043
Mailing Address - Street 1:1325 WRIGHT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2226
Mailing Address - Country:US
Mailing Address - Phone:337-783-4043
Mailing Address - Fax:337-783-4053
Practice Address - Street 1:1307 CROWLEY RAYNE HWY
Practice Address - Street 2:STE. C
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-8210
Practice Address - Country:US
Practice Address - Phone:337-788-3032
Practice Address - Fax:337-783-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1075728Medicaid
LA1235279043OtherNPI INDIVIDUAL
LA4355378620OtherBLUE CROSS BLUE SHIELD
LA1235279043OtherNPI INDIVIDUAL