MEDICARE: VERNEICA ANN WALKER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	358117	NC
2	163WG0600X	Gerontology Registered Nurse	N27602	NY

General Provider Information

NPI Number	:	1770954018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERNEICA ANN WALKER RN

Provider Business Mailing Address
First Line	:	541 HOLLYBERRY LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1608
Country	:	US
Telephone Number	:	252-378-0908
Fax Number	:

Provider Business Practice Location Address
First Line	:	541 HOLLYBERRY LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-1608
Country	:	US
Telephone Number	:	845-784-8851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2015
Last Update Date	:	03/24/2026

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