Provider Demographics
NPI:1699843193
Name:WALKER, ANN CHRISTINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CHRISTINE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 KILLIAN RD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9751
Mailing Address - Country:US
Mailing Address - Phone:330-780-8180
Mailing Address - Fax:
Practice Address - Street 1:2500 KILLIAN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9751
Practice Address - Country:US
Practice Address - Phone:330-780-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 099880164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2950089OtherMEDICAID LEGACY IP NUMBER