Provider Demographics
NPI:1831977404
Name:WALKER, MAEGAN CONROY
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:CONROY
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAEGAN
Other - Middle Name:ALLISON
Other - Last Name:CONROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7112 STOCKTON DUNES ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-4063
Mailing Address - Country:US
Mailing Address - Phone:806-281-3774
Mailing Address - Fax:
Practice Address - Street 1:2550 NATURE PARK DR STE 250
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-3206
Practice Address - Country:US
Practice Address - Phone:702-859-4710
Practice Address - Fax:702-859-4711
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist