Provider Demographics
NPI:1891937702
Name:WALKER, JOANN VANTA (RN)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:VANTA
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 1:1811 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3001
Mailing Address - Country:US
Mailing Address - Phone:480-831-7566
Mailing Address - Fax:
Practice Address - Street 1:2770 E VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6088
Practice Address - Country:US
Practice Address - Phone:602-273-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN045497163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse