Provider Demographics
NPI:1275636128
Name:WALKER, PHILOMENA (PA)
Entity Type:Individual
Prefix:
First Name:PHILOMENA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:PHILOMENA
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1950 LAUREL MANOR DR
Mailing Address - Street 2:STE 224
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:352-751-6565
Mailing Address - Fax:352-205-7777
Practice Address - Street 1:1950 LAUREL MANOR DR STE 224
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5602
Practice Address - Country:US
Practice Address - Phone:352-751-6565
Practice Address - Fax:352-205-7777
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2083363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290180300Medicaid
FL290180300Medicaid
FLE3703ZMedicare ID - Type Unspecified