Provider Demographics
NPI:1245755180
Name:WALKER, MARRISSA (RPH)
Entity Type:Individual
Prefix:DR
First Name:MARRISSA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 CAPITAL CIR SW STE 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7886
Mailing Address - Country:US
Mailing Address - Phone:850-878-1740
Mailing Address - Fax:
Practice Address - Street 1:5032 CAPITAL CIR SW STE 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7886
Practice Address - Country:US
Practice Address - Phone:850-878-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist