Provider Demographics
NPI:1609341288
Name:WALKER, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
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 1:18350 NW 2ND AVE STE 624
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4570
Mailing Address - Country:US
Mailing Address - Phone:305-756-9947
Mailing Address - Fax:305-756-9948
Practice Address - Street 1:18350 NW 2ND AVE STE 624
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4570
Practice Address - Country:US
Practice Address - Phone:305-756-9947
Practice Address - Fax:305-756-9948
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64978005374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide