1790924363 NPI number — HOLLY N WALKER ARNP

Table of content: HOLLY N WALKER ARNP (NPI 1790924363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790924363 NPI number — HOLLY N WALKER ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
HOLLY
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790924363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 950202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40295-0202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-969-6552
Provider Business Mailing Address Fax Number:
502-969-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 E GRAY ST
Provider Second Line Business Practice Location Address:
SUITE 1105
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-3900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-583-1609
Provider Business Practice Location Address Fax Number:
502-583-2120
Provider Enumeration Date:
02/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  5887P , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000616408 . This is a "SIHO- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5887P . This is a "KY BOARD OF LICENSE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7100091920 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000023036N . This is a "HUMANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200952380 . This is a "HEALTHY INDIANA PLAN- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200952380 . This is a "MD WISE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50023978 . This is a "PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000616408 . This is a "ANTHEM- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 200952380 . This is a "MEDICAID INDIANA- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3715729000 . This is a "PASSPORT ADVANTAGE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 00533133 . This is a "MEDICARE KY- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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