Provider Demographics
NPI:1548740145
Name:WALKER, ZINA
Entity Type:Individual
Prefix:
First Name:ZINA
Middle Name:
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 1:3785 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-6420
Mailing Address - Country:US
Mailing Address - Phone:901-743-0202
Mailing Address - Fax:901-774-7342
Practice Address - Street 1:3785 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-6420
Practice Address - Country:US
Practice Address - Phone:901-743-0202
Practice Address - Fax:901-774-7342
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN066068102343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)