Healthcare Provider Details

I. General information

NPI: 1053978932
Provider Name (Legal Business Name): CHAUNELL WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 BRINWAY DR
WEST MIFFLIN PA
15122-2612
US

IV. Provider business mailing address

3500 BRINWAY DR
WEST MIFFLIN PA
15122-2612
US

V. Phone/Fax

Practice location:
  • Phone: 412-508-7399
  • Fax:
Mailing address:
  • Phone: 412-508-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: