Provider Demographics
NPI:1700217775
Name:WALKER, SYLVIA (RN)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
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 1:2 INDEPENDENT DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-5058
Mailing Address - Country:US
Mailing Address - Phone:904-634-7607
Mailing Address - Fax:
Practice Address - Street 1:2 INDEPENDENT DR
Practice Address - Street 2:SUITE 108
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-5058
Practice Address - Country:US
Practice Address - Phone:904-634-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31440225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist