Provider Demographics
NPI:1609445923
Name:WALKER, TAMARIO (FNP)
Entity type:Individual
Prefix:
First Name:TAMARIO
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 STATE HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-9027
Mailing Address - Country:US
Mailing Address - Phone:870-702-6128
Mailing Address - Fax:901-257-4443
Practice Address - Street 1:1120 STATE HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-9027
Practice Address - Country:US
Practice Address - Phone:870-702-6128
Practice Address - Fax:901-257-4443
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily