Provider Demographics
NPI:1033773098
Name:WALKER, CALANDRA RAE (CNA)
Entity Type:Individual
Prefix:MRS
First Name:CALANDRA
Middle Name:RAE
Last Name:WALKER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-2057
Mailing Address - Country:US
Mailing Address - Phone:813-260-9672
Mailing Address - Fax:
Practice Address - Street 1:2609 15TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-2057
Practice Address - Country:US
Practice Address - Phone:813-260-9672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty