Provider Demographics
NPI:1942064324
Name:GRAY-WALKER, ALYSSHA PATRICE (LPN)
Entity Type:Individual
Prefix:
First Name:ALYSSHA
Middle Name:PATRICE
Last Name:GRAY-WALKER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6039 THOUSAND OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-5628
Mailing Address - Country:US
Mailing Address - Phone:419-270-4973
Mailing Address - Fax:
Practice Address - Street 1:6039 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-5628
Practice Address - Country:US
Practice Address - Phone:419-270-4973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.1877053747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant