Provider Demographics
NPI:1154312064
Name:WALKER, SAMARA WILLIAMS (RN)
Entity Type:Individual
Prefix:MRS
First Name:SAMARA
Middle Name:WILLIAMS
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 RIDGE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-1862
Mailing Address - Country:US
Mailing Address - Phone:757-838-0788
Mailing Address - Fax:
Practice Address - Street 1:BLDG 576 JEFFERSON AVENUE
Practice Address - Street 2:MCDONALD ARMY COMMUNITY HOSPI
Practice Address - City:FORT EUSTIS
Practice Address - State:VA
Practice Address - Zip Code:23604
Practice Address - Country:US
Practice Address - Phone:757-314-7597
Practice Address - Fax:757-314-7703
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001120977163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management