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General NPI Number Information
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NPI Number | 1922386218
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Entity Type | Individual
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Provider Name | SONIA LESLIE WALKER NP-C
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Gender | Female
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3855 AZALEA DR
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City | JACKSON
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State | MS
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Zip | 39206-5105
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Country | US
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Telephone | 601-366-9447
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Fax | 601-366-9790
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Provider Business Mailing Address
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Address Line | 3855 AZALEA DR
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City | JACKSON
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State | MS
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Zip | 39206-5105
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Country | US
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Telephone | 601-366-9447
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Fax | 601-366-9790
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R867644
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License Number State | MS
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