Healthcare Provider Details

I. General information

NPI: 1417766106
Provider Name (Legal Business Name): ROSITA WALKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8656 W GAGE BLVD STE A-106
KENNEWICK WA
99336-1150
US

IV. Provider business mailing address

4519 W 10TH AVE
KENNEWICK WA
99336-9301
US

V. Phone/Fax

Practice location:
  • Phone: 509-460-1065
  • Fax:
Mailing address:
  • Phone: 325-428-8974
  • Fax: 509-376-9119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP70006723
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN60912844
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1205730
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN60912844
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN60912844
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number324709
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: