Healthcare Provider Details

I. General information

NPI: 1245158377
Provider Name (Legal Business Name): CONCHETTA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 LAWYERS LN
COLUMBUS GA
31906-3129
US

IV. Provider business mailing address

919 LAWYERS LN
COLUMBUS GA
31906-3129
US

V. Phone/Fax

Practice location:
  • Phone: 706-256-3200
  • Fax: 706-317-2177
Mailing address:
  • Phone: 706-256-3200
  • Fax: 706-317-2177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: