Provider Demographics
NPI:1255540035
Name:WALKER, MARK ALLEN (ARNP-C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ALLEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-416-4970
Mailing Address - Fax:850-416-4969
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8721
Practice Address - Country:US
Practice Address - Phone:850-416-4970
Practice Address - Fax:850-416-4969
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9198986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily