Provider Demographics
NPI:1942955539
Name:WALKER, MARGUERITE
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 MAPLE FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-7739
Mailing Address - Country:US
Mailing Address - Phone:135-255-1586
Mailing Address - Fax:
Practice Address - Street 1:812 MAPLE FOREST AVE
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-7739
Practice Address - Country:US
Practice Address - Phone:135-255-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL681853696372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion