Healthcare Provider Details

I. General information

NPI: 1750009130
Provider Name (Legal Business Name): SYDNEY WALKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N WARSON RD STE 132W
SAINT LOUIS MO
63132-1113
US

IV. Provider business mailing address

1515 N WARSON RD STE 132W
SAINT LOUIS MO
63132-1113
US

V. Phone/Fax

Practice location:
  • Phone: 314-874-2262
  • Fax:
Mailing address:
  • Phone: 314-874-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2021030482
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: