Provider Demographics
NPI:1801278437
Name:WALKER, OLIVIA HADDAD (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:OLIVIA
Middle Name:HADDAD
Last Name:WALKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1317
Mailing Address - Country:US
Mailing Address - Phone:985-384-2430
Mailing Address - Fax:985-384-2473
Practice Address - Street 1:1055 DAVID DR
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1317
Practice Address - Country:US
Practice Address - Phone:985-384-2430
Practice Address - Fax:985-384-2473
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN131155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2398458Medicaid