Healthcare Provider Details

I. General information

NPI: 1750172565
Provider Name (Legal Business Name): NAKIMAH WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 MCCLELLAN AVE
PENNSAUKEN NJ
08109-4613
US

IV. Provider business mailing address

1961 PARK BLVD
CAMDEN NJ
08103-3614
US

V. Phone/Fax

Practice location:
  • Phone: 856-361-1100
  • Fax:
Mailing address:
  • Phone: 954-274-3845
  • Fax: 954-274-3845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number26NP07397600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: