Healthcare Provider Details

I. General information

NPI: 1508862517
Provider Name (Legal Business Name): JANICE YVONNE WALKER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST TEAL TEAM
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

5201 RAYMOND ST TEAL TEAM
ORLANDO FL
32803-8208
US

V. Phone/Fax

Practice location:
  • Phone: 407-629-1599
  • Fax:
Mailing address:
  • Phone: 407-629-1599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP 9244938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: