Provider Demographics
NPI:1881192573
Name:LABEE-WALKER, THEONIE CHARNETHIA (RN)
Entity Type:Individual
Prefix:
First Name:THEONIE
Middle Name:CHARNETHIA
Last Name:LABEE-WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:THEONIE
Other - Middle Name:CHARNETHIA
Other - Last Name:LABEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:47 CYPRESS MEADOW LOOP
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-5215
Mailing Address - Country:US
Mailing Address - Phone:253-318-9564
Mailing Address - Fax:
Practice Address - Street 1:47 CYPRESS MEADOW LOOP
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460-5215
Practice Address - Country:US
Practice Address - Phone:253-318-9564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-27
Last Update Date:2018-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00173294163W00000X, 163WC0400X
171M00000X, 372600000X, 3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant