Provider Demographics
NPI:1750962775
Name:WALKER, LAKEISHA MARIKA
Entity type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:MARIKA
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:PO BOX 1033
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1033
Mailing Address - Country:US
Mailing Address - Phone:804-664-6652
Mailing Address - Fax:
Practice Address - Street 1:36 CHASE GAYTON CIR APT 931
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-6542
Practice Address - Country:US
Practice Address - Phone:804-664-6652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14011341193747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant