DEREK N WALCKER (NPI# 1285286831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285286831 |
| Entity Type | Individual |
| Full Name | DEREK N WALCKER |
| Credential | PMHNP |
| Practice Address |
5850 Waterloo Rd Ste 140 Columbia MD 21045-1944 |
| Mailing Address |
3814 Plum Meadow Dr Ellicott City MD 21042-5126 |
| Practice Telephone | 4109882503 |
| Practice Fax Number | 4103437899 |
| Mailing Telephone | 2407232671 |
| Enumeration Date | 2019-07-14 |
| Last Update Date | 2020-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
R189093 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN.CNP.025119 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 807 E Washington St Ste 220, Medina, OH 442563330 | 3305363746 |
| Street Address |
5850 WATERLOO RD STE 140 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045-1944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922443324 | Cohen Dermatopathology, PC | Dermatology | 5850 Waterloo Rd Ste 140, Columbia, MD 21045 | 2013-04-30 |
| 1699254292 | Steven M Gordon LLC | Nurse Practitioner | 5850 Waterloo Rd Ste 140, Columbia, MD 21045 | 2018-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906879 | Claudine Njob | Nurse Practitioner | 5500 Knoll North Dr Ste 220, Columbia, MD 21045-2362 | 2020-09-15 |
| 1366081887 | Mavis Kisseadoo | Nurse Practitioner | 10208 Hickory Ridge Rd Apt 302, Columbia, MD 21044-4688 | 2020-01-01 |
| 1942768528 | American Psychiatric Care LLC | Nurse Practitioner | 8895 Centre Park Dr Ste E2, Columbia, MD 21045-1966 | 2019-03-04 |
| 1700341948 | Anu John | Nurse Practitioner | G. Werber Bryan Psychiatric Hospital, 220 Faison Drive, Columbia, SC 29203 | 2019-02-01 |
| 1457838633 | Lisa Eunjoo Sohn | Nurse Practitioner | 6310 Stevens Forest Rd Ste 100, Columbia, MD 21046-3208 | 2018-07-20 |
| 1558864157 | Yetunde Olaleye | Nurse Practitioner | 7067 Columbia Gateway Dr Ste 108, Columbia, MD 21046-3407 | 2018-03-10 |
| 1538667431 | Truhope.3 LLC | Nurse Practitioner | 10440 Little Patuxent Pkwy Ste 300, Columbia, MD 21044-3648 | 2018-01-25 |
| 1174038590 | Elizabeth Jane Eggebrecht | Nurse Practitioner | 2715 Colonial Dr Ste 100, Columbia, SC 29203-6818 | 2017-12-07 |
| 1639540420 | Stacy S Mallare | Nurse Practitioner | 10954 Hilltop Ln, Columbia, MD 21044-3780 | 2015-10-19 |
| 1790097913 | Ana C Duarte | Nurse Practitioner | 10632 Little Patuxent Pkwy Ste 410, Columbia, MD 21044-3252 | 2010-07-02 |
| Find all providers in COLUMBIA | ||||
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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.