Provider Demographics
NPI:1700404084
Name:WALKER, SHAREE NACOLE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:SHAREE
Middle Name:NACOLE
Last Name:WALKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 STONEWALL ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5983
Mailing Address - Country:US
Mailing Address - Phone:405-476-8388
Mailing Address - Fax:
Practice Address - Street 1:401 STONEWALL ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-5983
Practice Address - Country:US
Practice Address - Phone:405-476-8388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014059363L00000X, 363LF0000X
NCF06200958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily