Provider Demographics
NPI:1003858929
Name:WALKER, DONNA CARLSON (PT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:CARLSON
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 FOUNTAIN CT
Mailing Address - Street 2:SUITE 325
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1895
Mailing Address - Country:US
Mailing Address - Phone:859-263-0595
Mailing Address - Fax:859-263-0385
Practice Address - Street 1:230 FOUNTAIN CT
Practice Address - Street 2:SUITE 325
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1895
Practice Address - Country:US
Practice Address - Phone:859-263-0595
Practice Address - Fax:859-263-0385
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000886225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7311873OtherAETNA
KY000000542810OtherANTHEM BC
KY204579943OtherHUMANA
KY611938100OtherUS DEPT OF LABOR
KY7311873OtherAETNA
KY204579943OtherHUMANA