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General NPI Number Information
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NPI Number | 1407030620
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Entity Type | Individual
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Provider Name | DANA WICKER WALKER DPH
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Gender | Female
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 102 W JACKSON BLVD
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City | JONESBOROUGH
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State | TN
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Zip | 37659-1224
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Country | US
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Telephone | 423-753-4446
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Fax | 423-753-4587
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Provider Business Mailing Address
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Address Line | 102 W JACKSON BLVD
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City | JONESBOROUGH
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State | TN
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Zip | 37659-1224
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Country | US
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Telephone | 423-753-4446
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Fax | 423-753-4587
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5972
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License Number State | TN
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