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General NPI Number Information
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NPI Number | 1689263931
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Entity Type | Individual
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Provider Name | LAURA RAVENEL WALKER RN
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Gender | Female
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 4030 HIGHWAY 6 S STE 325
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City | COLLEGE STATION
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State | TX
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Zip | 77845-1803
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Country | US
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Telephone | 979-431-3380
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Fax | 979-690-1008
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Provider Business Mailing Address
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Address Line | 8370 COUNTY ROAD 150
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City | CALDWELL
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State | TX
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Zip | 77836-5612
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Country | US
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Telephone | 985-710-1878
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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 | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | 109073
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License Number State | LA
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