Provider Demographics
NPI:1871752550
Name:WALKER, PEGGY JEAN (RN MSN CADC)
Entity type:Individual
Prefix:MR
First Name:PEGGY
Middle Name:JEAN
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN MSN CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 EAST MOORE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143
Mailing Address - Country:US
Mailing Address - Phone:501-268-7777
Mailing Address - Fax:501-305-5009
Practice Address - Street 1:3204 E MOORE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4826
Practice Address - Country:US
Practice Address - Phone:501-268-7777
Practice Address - Fax:501-305-5009
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR21091163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator