Maya M Walkington-Stauber, GNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R1053357 Issued in MN

Practice address

3400 W 66TH St
#290
Edina, MN 55435-2111

Phone

(952) 914-1969

NPI assigned

Mar 16, 2006

Last updated

Apr 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1164491676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16555 KLAMATH TER",
            "address_2": "16555 KLAMATH TERRACE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448425",
            "telephone_number": "612-859-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 66TH ST",
            "address_2": "#290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352111",
            "telephone_number": "952-914-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKINGTON-STAUBER",
        "first_name": "MAYA",
        "middle_name": "M",
        "credential": "GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R1053357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walker Assisted Living Corporation I (Walker Methodist Care Suites)
• Holly Louise Walker, CMT
• Justin Andrew Walker, MD
• Lori Walker, LMFT
• Robert Norman Walker, M.D.
• Robert J Walkowski, PAC
• Melanie Waller, LICSW
• Elizabeth Wallis, PA-C
• Laurie Kathryn Walsh, R.N., C.N.P.
• Sabrina Marie Walski-Easton, M.D.

• Gerontology Nurse Practitioner in Edina, MN
• Providers in Edina, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.