Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 25263 | SC |
NPI | 1013688969 |
---|---|
Provider Name | Mrs. Deborah L Walker |
First Address | Goose Creek, SC 29445-7192 |
Second Address | Charleston, SC 29401-1113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2021 |
Last Update Date | 21/09/2021 |