Healthcare Provider Details

I. General information

NPI: 1366356420
Provider Name (Legal Business Name): KENNETH WALKER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7420 BRADFORD CT
MOBILE AL
36695-4422
US

IV. Provider business mailing address

PO BOX 161461
MOBILE AL
36616-2461
US

V. Phone/Fax

Practice location:
  • Phone: 251-581-5066
  • Fax:
Mailing address:
  • Phone: 251-581-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: