Provider Demographics
NPI:1083217541
Name:WALKER, NIKIAH ROSE (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:NIKIAH
Middle Name:ROSE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W SHARPNACK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-4034
Mailing Address - Country:US
Mailing Address - Phone:267-990-9013
Mailing Address - Fax:
Practice Address - Street 1:19 W HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-4034
Practice Address - Country:US
Practice Address - Phone:215-383-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist