Provider Demographics
NPI:1417363755
Name:WALKER, BROOKE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WESTFIELDS CT
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8772
Mailing Address - Country:US
Mailing Address - Phone:337-945-7712
Mailing Address - Fax:
Practice Address - Street 1:124 WESTFIELDS CT
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8772
Practice Address - Country:US
Practice Address - Phone:337-945-7712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA046425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist