Provider Information for 1205482833
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TONYA WALKER
Sex: Female
NPI: 1205482833
Last Updated: 2023-12-01
Certification Date: 2023-11-30
Certification Date: 2023-11-30
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1205482833 | ||||||||
| Enumeration Date | 2019-08-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 245 S 84TH ST STE L101 LINCOLN, NE 68510-2601 United States Phone: 402-421-1182 | Fax: | ||||||||
| Primary Practice Address | 2349 NM-522 SUITE 5 QUESTA, NM 87556 United States Phone: 402-418-8848 | Fax: | ||||||||
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