Provider Demographics
NPI:1942291984
Name:WALKER, JOAN RUTH (LPN, RRT, CCPT, CPFT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:RUTH
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPN, RRT, CCPT, CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 W BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:01531-1553
Mailing Address - Country:US
Mailing Address - Phone:508-867-6928
Mailing Address - Fax:508-867-6928
Practice Address - Street 1:1290 W BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:NEW BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:01531-1553
Practice Address - Country:US
Practice Address - Phone:508-867-6928
Practice Address - Fax:508-867-6928
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA33272164W00000X
MA1065227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Not Answered227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered