Provider Demographics
NPI:1689263931
Name:WALKER, LAURA RAVENEL (RN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RAVENEL
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:8370 COUNTY ROAD 150
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:TX
Mailing Address - Zip Code:77836-5612
Mailing Address - Country:US
Mailing Address - Phone:985-710-1878
Mailing Address - Fax:
Practice Address - Street 1:4030 HIGHWAY 6 S STE 325
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-1803
Practice Address - Country:US
Practice Address - Phone:979-431-3380
Practice Address - Fax:979-690-1008
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA109073364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health