Provider Demographics
NPI:1578233979
Name:WALKER, AIMEE NICHOLE
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:NICHOLE
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 1:139 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLENDENIN
Mailing Address - State:WV
Mailing Address - Zip Code:25045-9280
Mailing Address - Country:US
Mailing Address - Phone:304-704-9311
Mailing Address - Fax:
Practice Address - Street 1:139 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:CLENDENIN
Practice Address - State:WV
Practice Address - Zip Code:25045-9280
Practice Address - Country:US
Practice Address - Phone:304-704-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant