Walker, Mallori

Walker, Mallori is an individual health care provider with primary practice located at 253 Sagamore Pkwy W , West Lafayette IN 47906-1501. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Walker, Mallori can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
253 Sagamore Pkwy W West Lafayette IN 47906-1501
Phone: (765) 448-8000
Fax: (765) 448-7611
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 28180875A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 71005771A Indiana

Profile Details

NPI number 1295110336
LBN Legal business name Walker, Mallori
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2015
Last updated Mar 1st, 2021 - about 5 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 1295110336 NPPES
Indiana MEDICAID PENDING
Indiana Other 000000964736

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