Provider Demographics
NPI:1053676007
Name:WALKER-HOWARD, MARY
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:WALKER-HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W. HILL STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5361
Mailing Address - Country:US
Mailing Address - Phone:704-605-8219
Mailing Address - Fax:
Practice Address - Street 1:800 W HILL ST
Practice Address - Street 2:SUITE 207
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5360
Practice Address - Country:US
Practice Address - Phone:704-605-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC45503747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant