Provider Demographics
NPI:1235970708
Name:WALKER, TERESA ANN
Entity type:Individual
Prefix:MISS
First Name:TERESA
Middle Name:ANN
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 1:721 LOOP ST
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-1909
Mailing Address - Country:US
Mailing Address - Phone:937-866-2827
Mailing Address - Fax:
Practice Address - Street 1:721 LOOP ST
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-1909
Practice Address - Country:US
Practice Address - Phone:937-866-2827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker