Active NPI
Bonnie Lee Walker, RN
- Clinical Nurse Specialist
- Greenville, SC
National Provider Identifier
1073213492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- 236405
- Practice address
- 120 Lake Circle Dr
Greenville, SC 29609-6622 - Phone
- (570) 581-0675
- NPI assigned
- Mar 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | 236405 | SC | Primary |
Addresses
Primary practice location
120 Lake Circle Dr
Greenville, SC 29609-6622
Mailing address
120 Lake Circle Dr
Greenville, SC 29609-6622
Phone (570) 581-0675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236405 | SC | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1073213492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 LAKE CIRCLE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296096622",
"telephone_number": "570-581-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 LAKE CIRCLE DR",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296096622",
"telephone_number": "570-581-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "BONNIE",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-06",
"last_updated": "2023-03-06",
"certification_date": "2023-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "SC",
"license": "236405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.