DR. SHIANNA RENAE WALKER (NPI# 1104180405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104180405 |
| Entity Type | Individual |
| Full Name | DR. SHIANNA RENAE WALKER |
| Credential | PH.D. |
| Practice Address |
1060 Gaffney Rd #7440 Fort Wainwright AK 99703-5001 |
| Practice Telephone | 9073615418 |
| Practice Fax Number | 9073614847 |
| Mailing Telephone | 9073615418 |
| Mailing Fax Number | 9073614847 |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 019763-1 | NY | Behavioral Health & Social Service Providers |
| Street Address |
1060 GAFFNEY RD #7440 |
| City | FORT WAINWRIGHT |
| State | AK |
| Zip Code | 99703-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033191192 | Elizabeth Ann Mittelstaedt | Registered Nurse | 1060 Gaffney Rd, Commander, Usa-meddac-ak, Attn: Mcuc-mmd-qm, Fort Wainwright, AK 99703-5001 | 2005-11-15 |
| 1952858615 | Patrick Degen Bushman | Physician Assistant | 1060 Gaffney Rd, #7440, Fort Wainwright, AK 99703-5002 | 2016-09-09 |
| 1043764939 | Laurence Preston Keim | Physician Assistant | 1060 Gaffney Rd, Fort Wainwright, AK 99703-5002 | 2016-08-08 |
| 1275985152 | Monica Wyatt | Nurse Practitioner | 1060 Gaffney Rd, Fort Wainwright, AK 99703-5002 | 2016-07-05 |
| 1700235546 | Tyler Tubbs | Dental Assistant | 1060 Gaffney Rd, 1055, Fort Wainwright, AK 99703-5002 | 2016-06-10 |
| 1285037796 | Tina Syfert | Nurse Practitioner | 1060 Gaffney Rd, Fort Wainwright, AK 99703-5002 | 2014-09-29 |
| 1841617586 | Keng Yu Chen | Dentist | 1060 Gaffney Rd, #7500, Fort Wainwright, AK 99703-5001 | 2014-03-19 |
| 1831539378 | Laina Gay Cafego | Family Medicine | 1060 Gaffney Rd, Bassett Army Community Hospital, Fort Wainwright, AK 99703 | 2013-06-28 |
| 1467890798 | Jennifer Myaeng | Pediatrics | 1060 Gaffney Rd, Fort Wainwright, AK 99703-5002 | 2013-06-09 |
| 1598100745 | Andrea Christina Knievel | General Practice | 1060 Gaffney Rd, Fort Wainwright, AK 99703-5002 | 2013-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144866435 | Rebecca P Conner | Registered Nurse | Bach, 1060 Gafney Rd, Ft Wainwright, AK 99703 | 2019-11-21 |
| 1881242030 | Stephanie Morse | Counselor | Bldg 3406 Alder Ave, Ft. Wainwright, AK 99703 | 2019-08-30 |
| 1801376702 | Matthew Gerard Somma | Physician Assistant | 1-25 Attack Reconnaissance Bn, Fort Wainwright, AK 99703 | 2018-08-20 |
| 1003268657 | Brandy Tristan | Dental Hygienist | Bldg 3406, Troop Dental Clinic, Ft. Wainwright, AK 99703 | 2016-07-07 |
| 1174998918 | Jeffrey Grace | Physician Assistant | Bassett Army Medical Center (kamish Clinic), 1060 Gaffney Rd, Ft Wainwright, AK 99703 | 2015-12-04 |
| 1073999215 | Melanie Anne Whalen | Dentist | 4055 Tamarak Dr, Ft Wainwright, AK 99703 | 2015-08-10 |
| 1790183176 | Sally Jane Rall | Counselor | 3406 Adler Ave, Fairbanks, AK 99703 | 2014-12-16 |
| 1083029193 | Francesann Hill | General Practice | 3214 East Santiago Avenue, Apo, AP 99703 | 2014-06-26 |
| 1669883146 | Amber Benton | Psychiatry & Neurology | 4005-4007 602nd St, Fort Wainwright, AK 99703 | 2014-05-18 |
| 1952720898 | Allison Hubert | Occupational Therapist | 3410 Rhineland Ave, Rm 108, Fort Wainwright, AK 99703 | 2014-04-08 |
| Find all providers in zip 99703 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245542448 | Kara Stocker | Clinical Neuropsychologist | 707 A St Ste 115, Anchorage, AK 99501-3600 | 2010-07-06 |
| 1851578512 | Dustin M Logan | Clinical Neuropsychologist | 8201 N Michaelson St, Palmer, AK 99645-8196 | 2008-01-24 |
| 1639396682 | James M. May | Clinical Neuropsychologist | 3650 Campbell Rd., Palmer, AK 99645 | 2007-04-19 |
| 1962526517 | Keith A. Youngblood | Clinical Neuropsychologist | 7331 Clairborne Dr, Anchorage, AK 99502-7119 | 2007-03-19 |
| 1477685246 | Paul L Craig | Clinical Neuropsychologist | 4048 Laurel St Ste 102, Anchorage, AK 99508-5389 | 2007-03-09 |
| 1750422556 | D V Digiulio Phd | Clinical Neuropsychologist | 2770 Sherwood Ln Ste 1d, Juneau, AK 99801-8568 | 2007-02-12 |
| 1861430803 | Diane V Digiulio | Clinical Neuropsychologist | 2770 Sherwood Ln # D, Juneau, AK 99801-8568 | 2006-06-03 |
| 1326095837 | Russell S Cherry | Clinical Neuropsychologist | 4241 B St, Suite 202, Anchorage, AK 99503-5920 | 2006-05-28 |
| 1700865029 | Kristi H Fuller | Clinical Neuropsychologist | 2600 Denali St, Suite 450, Anchorage, AK 99503-2746 | 2006-01-13 |
| 1669474136 | Cindy Kingry Westergaard | Clinical Neuropsychologist | 201 Lincoln Street Suite 3, 209 Moller Drive, Sitka, AK 99835 | 2005-08-12 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAINWRIGHT |
| Zip Code | 99703 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.