Provider Demographics
NPI:1497991558
Name:WALKER, CYNTHIA SUE (RD)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:SUE
Last Name:WALKER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MOORESVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-0304
Mailing Address - Country:US
Mailing Address - Phone:704-920-1000
Mailing Address - Fax:704-920-1002
Practice Address - Street 1:300 MOORESVILLE ROAD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-0304
Practice Address - Country:US
Practice Address - Phone:704-920-1000
Practice Address - Fax:704-920-1002
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000402133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered