Provider Demographics
NPI:1164105573
Name:WALKER, DYNESHA D
Entity Type:Individual
Prefix:
First Name:DYNESHA
Middle Name:D
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 1:1630 BALKIN RD LOT 77
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7229
Mailing Address - Country:US
Mailing Address - Phone:850-509-7570
Mailing Address - Fax:
Practice Address - Street 1:1630 BALKIN RD LOT 77
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7229
Practice Address - Country:US
Practice Address - Phone:850-509-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula