Provider Demographics
NPI:1598154395
Name:WALKER, RIKKI LEA (RN)
Entity Type:Individual
Prefix:MISS
First Name:RIKKI
Middle Name:LEA
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-1116
Mailing Address - Country:US
Mailing Address - Phone:315-297-3355
Mailing Address - Fax:
Practice Address - Street 1:11 E 4TH ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-1116
Practice Address - Country:US
Practice Address - Phone:315-297-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319230-1164W00000X
NY810726163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No164W00000XNursing Service ProvidersLicensed Practical Nurse