Provider Demographics
NPI:1861003881
Name:WALKER WELLNESS & DIABETES EDUCATION, LLC
Entity Type:Organization
Organization Name:WALKER WELLNESS & DIABETES EDUCATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN,CDE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-295-6533
Mailing Address - Street 1:1289 S 1000 E
Mailing Address - Street 2:
Mailing Address - City:CANNELBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47519-5035
Mailing Address - Country:US
Mailing Address - Phone:812-295-6533
Mailing Address - Fax:
Practice Address - Street 1:100 THARP STREET SUITE B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-4228
Practice Address - Country:US
Practice Address - Phone:812-642-5060
Practice Address - Fax:812-642-5048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty