Provider Demographics
NPI:1336602374
Name:WALKER, TERRI ANN (BIRTHING DOULA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:BIRTHING DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3347 FM 1283
Mailing Address - Street 2:
Mailing Address - City:PIPE CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78063-6066
Mailing Address - Country:US
Mailing Address - Phone:210-833-2395
Mailing Address - Fax:
Practice Address - Street 1:3347 FM 1283
Practice Address - Street 2:
Practice Address - City:PIPE CREEK
Practice Address - State:TX
Practice Address - Zip Code:78063-6066
Practice Address - Country:US
Practice Address - Phone:210-833-2395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-08
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3061174N00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3016OtherIDI