MEDICARE: RASHEKA WALTERS PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5023799	NC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	258993	SC

General Provider Information

NPI Number	:	1912876889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHEKA WALTERS PMHNP-BC

Provider Business Mailing Address
First Line	:	1221 RUSSELL ST
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29730-5647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 E INDEPENDENCE BLVD STE 501
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-5494
Country	:	US
Telephone Number	:	704-388-6736
Fax Number	:	949-695-3608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	02/12/2026

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