Fay Walker
Nurse Practitioner in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1093380974
StatusActive
Last updated in NPPESMay 24, 2021
Details
- NPI
- 1093380974
- Entity type
- Individual (NPI-1)
- Name
- Fay Walker
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 24, 2021
- Certification date
- May 24, 2021
- Last updated
- May 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71011149A | IN | Yes |
Other names
- Fay Jacquay (Former Name)
Practice location
5050 N Clinton StFort Wayne, IN 46825-5886
Phone 260-484-8551
Mailing address
5052 N Clinton StFort Wayne, IN 46825-5822
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