Provider Demographics
NPI:1043079825
Name:WALKER, CYBELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CYBELLE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 LOUISIANA DR.
Mailing Address - Street 2:7 MDG
Mailing Address - City:DYESS AFB
Mailing Address - State:TX
Mailing Address - Zip Code:79607
Mailing Address - Country:US
Mailing Address - Phone:325-696-3558
Mailing Address - Fax:325-696-3359
Practice Address - Street 1:697 LOUISIANA DR.
Practice Address - Street 2:7 MDG
Practice Address - City:DYESS AFB
Practice Address - State:TX
Practice Address - Zip Code:79607-1367
Practice Address - Country:US
Practice Address - Phone:325-696-3558
Practice Address - Fax:325-696-3359
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-107123171000000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No171000000XOther Service ProvidersMilitary Health Care Provider