Provider Demographics
NPI:1871824615
Name:WALKER, AYISHA KENNILL (RN)
Entity Type:Individual
Prefix:MRS
First Name:AYISHA
Middle Name:KENNILL
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:AYISHA
Other - Middle Name:KENNILL
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:114 ASHBROOK RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2210
Mailing Address - Country:US
Mailing Address - Phone:937-301-8066
Mailing Address - Fax:
Practice Address - Street 1:114 ASHBROOK RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2210
Practice Address - Country:US
Practice Address - Phone:937-301-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN317616163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health