Provider Demographics
NPI:1013393891
Name:WALKER, MISTY L (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MRS
Other - First Name:MISTY
Other - Middle Name:L
Other - Last Name:CRONEMILLER-WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:10019 S. MEMORIAL DR
Mailing Address - Street 2:CVS/TARGER
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133
Mailing Address - Country:US
Mailing Address - Phone:918-343-7457
Mailing Address - Fax:918-341-6278
Practice Address - Street 1:CVS/TARGET
Practice Address - Street 2:10019 S. MEMORIAL DR.
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133
Practice Address - Country:US
Practice Address - Phone:918-615-5001
Practice Address - Fax:918-615-5011
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10464183500000X
OK13637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist