Provider Demographics
NPI:1265045868
Name:WALKER, VICKIE C
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:C
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 1:311 LEE ST W APT C
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-2137
Mailing Address - Country:US
Mailing Address - Phone:304-993-1070
Mailing Address - Fax:
Practice Address - Street 1:311 LEE ST W APT C
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2137
Practice Address - Country:US
Practice Address - Phone:304-993-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant