Provider Demographics
NPI:1063033793
Name:WALKER, TOILICIA DANIELLE SYLVIA
Entity Type:Individual
Prefix:
First Name:TOILICIA
Middle Name:DANIELLE SYLVIA
Last Name:WALKER
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 1:239 E 43RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-5306
Mailing Address - Country:US
Mailing Address - Phone:904-872-0701
Mailing Address - Fax:
Practice Address - Street 1:239 E 43RD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-5306
Practice Address - Country:US
Practice Address - Phone:904-872-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide