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General NPI Number Information
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NPI Number | 1750080008
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Entity Type | Individual
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Provider Name | MICHELLE WALKER
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Gender | Female
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1705 SAINT MARY ST
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City | KNOXVILLE
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State | TN
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Zip | 37917-4510
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Country | US
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Telephone | 865-370-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 357 ASPEN DR
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City | LENOIR CITY
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State | TN
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Zip | 37771-2021
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 10695
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License Number State | TN
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