| Doctor Name: | MARY J WALKER |
| NPI Number: | 1023051067 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 5417 |
| Business Practice Address: | 465 Isbill Rd Madisonville, TN - 373542112 |
| Business Phone Number: | 8653350330 |
| Business Fax Number: | 8652731755 |
| Mailing Address: | P.o. Box 6307, MARYVILLE |
| State: | TN |
| Postal Code: | 378026307 |
| Phone Number: | 8652731752 |
| Fax Number: | 8652731755 |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 04/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5417 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |