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General NPI Number Information
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NPI Number | 1265381826
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Entity Type | Individual
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Provider Name | THERON K WALKER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 1600 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-3019
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Country | US
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Telephone | 863-680-7845
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Fax | 863-616-2493
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Provider Business Mailing Address
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Address Line | 4981 OLD BERKLEY RD
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City | AUBURNDALE
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State | FL
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Zip | 33823-8352
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Country | US
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Telephone | 863-224-9985
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5243696
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License Number State | FL
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