Nan Victoria Walker, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30002220 Issued in WA

Practice address

3322 Broadway
Suite 200
Everett, WA 98201-2777

Phone

(425) 249-4841

Fax

(425) 339-8283

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1649298787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITA 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908004317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 BROADWAY",
            "address_2": "SUITE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012777",
            "telephone_number": "425-249-4841",
            "fax_number": "425-339-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "NAN",
        "middle_name": "VICTORIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00103948",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30002220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9607128",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0155908",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDERONE ID",
            "identifier": "1015416",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD",
            "identifier": "55198U",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Walker
• Kaycee Walker
• Laurel K Walker, AU.D.
• Luke N Walker, MD
• Lyndal Walker, PHD
• Selena Walker
• Tralonda Olivia Walker
• Valla Penrose Walker, PSY.D.
• Dylan Lee Wall
• Gary A Wall Jr., D.D.S.

• Family Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.