Provider Demographics
NPI:1881298677
Name:WALKER, JOLENE M (LVN)
Entity type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
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Mailing Address - Street 1:5121 CRESTWAY DRIVE
Mailing Address - Street 2:SUITE 200B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239
Mailing Address - Country:US
Mailing Address - Phone:210-310-3864
Mailing Address - Fax:210-310-3719
Practice Address - Street 1:5121 CRESTWAY DRIVE
Practice Address - Street 2:SUITE 200B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239
Practice Address - Country:US
Practice Address - Phone:210-310-3864
Practice Address - Fax:210-310-3719
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX345478164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse