Provider Demographics
NPI:1730690371
Name:WALKER, DAISY MAY (PA-C)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:MAY
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 N CASTLE HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-5640
Mailing Address - Country:US
Mailing Address - Phone:423-352-4381
Mailing Address - Fax:423-352-4382
Practice Address - Street 1:1128 N CASTLE HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-5640
Practice Address - Country:US
Practice Address - Phone:423-352-4381
Practice Address - Fax:423-352-4382
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3473363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant