Provider Demographics
NPI:1437169422
Name:WALKER, LOIS STASH (RN,CS)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:STASH
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 GROVEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-3252
Mailing Address - Country:US
Mailing Address - Phone:703-978-2377
Mailing Address - Fax:
Practice Address - Street 1:3921 OLD LEE HWY
Practice Address - Street 2:SUITE 73A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2429
Practice Address - Country:US
Practice Address - Phone:703-758-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001067469163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health