Walker, Holly R

Walker, Holly R is an individual health care provider with primary practice located at 420 Ne Glen Oak Ave Ste 401 , Peoria IL 61603-3168. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Walker, Holly R can be contacted via phone (309) 676-8123.

Contact Information

Primary practice address
420 Ne Glen Oak Ave Ste 401 Peoria IL 61603-3168
Phone: (309) 676-8123
Fax: (309) 676-8455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085001719 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085001719 Illinois

Profile Details

NPI number 1497887004
LBN Legal business name Walker, Holly R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2007
Last updated Oct 29th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497887004 NPPES
Illinois Other P00300733 RAILROAD MEDICARE
Illinois MEDICAID 0850017179 RAILROAD MEDICARE

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