Provider Demographics
NPI:1982157160
Name:ARCHIE-WALKER, JUDEA DAVIDA-NAILENE (MED)
Entity Type:Individual
Prefix:
First Name:JUDEA
Middle Name:DAVIDA-NAILENE
Last Name:ARCHIE-WALKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1410
Mailing Address - Country:US
Mailing Address - Phone:804-926-5220
Mailing Address - Fax:
Practice Address - Street 1:1811 TIMBERLANE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1410
Practice Address - Country:US
Practice Address - Phone:804-926-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other