Provider Demographics
NPI:1770058612
Name:WALKER, PATRICIA MARIE (DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:MARIE
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6430 BEAVER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3346
Mailing Address - Country:US
Mailing Address - Phone:402-890-6134
Mailing Address - Fax:
Practice Address - Street 1:1750 S 20TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2611
Practice Address - Country:US
Practice Address - Phone:402-475-6791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist