Provider Demographics
NPI:1235732694
Name:WALKER, KIMBERLY R
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:R
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 1:1824 EUCLID AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41014-1024
Mailing Address - Country:US
Mailing Address - Phone:513-349-5748
Mailing Address - Fax:
Practice Address - Street 1:1824 EUCLID AVE APT 1
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41014-1024
Practice Address - Country:US
Practice Address - Phone:151-334-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide