Provider Demographics
NPI:1659037257
Name:WALKER, TERRI LYNN
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
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 1:7251 W LAKE MEAD BLVD STE 3007251
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-8351
Mailing Address - Country:US
Mailing Address - Phone:702-562-4344
Mailing Address - Fax:702-562-4345
Practice Address - Street 1:7251 W LAKE MEAD BLVD STE 3007251
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-8351
Practice Address - Country:US
Practice Address - Phone:702-562-4344
Practice Address - Fax:702-562-4345
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant